Patient Introduction: Marilyn Hughes, A 45-Year-Old Female ✓ Solved

Patient Introductionmarilyn Hughes Is A 45 Year Old Female Who Suffere

Marilyn Hughes is a 45-year-old female who suffered a left mid-shaft tibia-fibula fracture when she slipped on icy stairs this morning. She was taken to surgery for an open reduction with internal fixation (ORIF). She returned from surgery at 1:45 p.m. with a below-the-knee ace/splint dressing. Vital signs have been stable, and neurovascular checks have been within normal range. She has an IV of Lactated Ringer’s infusing at 75 mL/hour and is tolerating liquids well without nausea.

Her diet could probably be advanced to regular dinner this evening. A family member has been with her at the bedside throughout the day. She began complaining of pain shortly after returning from surgery and was given morphine 6 mg IV at 2:15 p.m. She is now on a postoperative vital signs monitoring every 30 minutes. The last vital signs recorded were blood pressure: 130/82 mm Hg, heart rate: 88 beats per minute, respiratory rate: 16 breaths per minute.

Sample Paper For Above instruction

Introduction

Postoperative care is vital in ensuring optimal recovery and preventing complications following surgical procedures such as open reduction and internal fixation (ORIF) for fractures. Marilyn Hughes, a 45-year-old female, presents a typical case where detailed nursing assessment, effective pain management, and vigilant monitoring are crucial components of patient care. Understanding her clinical picture allows healthcare providers to tailor interventions that promote healing, alleviate discomfort, and protect against potential postoperative risks.

Clinical Presentation and Initial Evaluation

Marilyn's presentation with a tibia-fibula fracture resulting from a slip on icy stairs is characteristic of outdoor winter trauma. Her initial assessment post-surgery indicates stable vital signs with a blood pressure of 130/82 mm Hg, HR of 88 bpm, and RR of 16/min, suggesting hemodynamic stability. Her neurovascular checks, which assess circulation, sensation, and motor function distal to the injury site, are within normal limits, indicating adequate perfusion and nerve integrity at this stage.

Postoperative pain management is a critical aspect of her care, as indicated by her reporting of pain shortly after returning from surgery and her subsequent administration of 6 mg IV morphine. Pain assessment should include evaluating intensity, location, radiation, and impact on activities, using standardized pain scales such as the Numeric Rating Scale (NRS) or Visual Analog Scale (VAS).

Monitoring and Interventions

Her current infusion of Lactated Ringer's at 75 mL/hour provides adequate hydration and supports tissue perfusion necessary for healing. The plan to advance her diet to regular dinner indicates stable gastrointestinal function, critical for postoperative nutrition. Regular neurovascular assessments are essential to promptly detect any signs of compartment syndrome, bleeding, or compromised circulation.

Periodic vital signs monitoring every 30 minutes allows early identification of hemodynamic instability, adverse drug reactions, or emergent complications such as hypovolemia or hypertension. Pain management strategies should balance effective analgesia with the minimization of opioid-related side effects such as respiratory depression, nausea, and constipation.

Complication Prevention and Patient Education

To prevent complications, nurses should monitor for signs of infection, deep vein thrombosis (DVT), and skin breakdown under the splint or cast. Encouraging mobility and physiotherapy as tolerated can reduce DVT risk and promote circulation. Education for Marilyn and her family about post-discharge care, signs of complications, medication adherence, and activity restrictions is pivotal for promoting recovery at home.

Conclusion

Marilyn Hughes's postoperative course exemplifies the importance of comprehensive nursing care, including vigilant vital sign monitoring, effective pain control, maintenance of hydration, and patient education. Tailoring interventions based on her condition ensures a safer recovery process, decreases complication rates, and enhances patient outcomes following orthopedic surgery.

References

• Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb's Fundamentals of Nursing (10th ed.). Pearson.
• Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nurses’ Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales (14th ed.). F. A. Davis Company.
• Hockenberry, M. J., & Wilson, D. (2018). Wong’s Nursing Care of Infants and Children (11th ed.). Elsevier.
• Kozier, B., Erb, G., & Berman, A. (2018). Foundations of Nursing (8th ed.). Pearson.
• Porth, C. M. (2019). Pathophysiology: Concepts of Altered Health States (10th ed.). Wolters Kluwer.
• Sullivan, D., & Garland, J. (2019). Effects of opioids in postoperative pain management. Journal of Pain & Symptom Management, 58(5), 798-805.
• Vaccaro, C., et al. (2020). Preventing Deep Vein Thrombosis in Orthopedic Patients. Journal of Orthopaedic Nursing, 24(3), 78-85.
• Walker, R., et al. (2017). Principles of Musculoskeletal Care. Oxford University Press.
• Williams, M. V., & Bruns, D. (2020). Postoperative Pain Management. Pain Therapy, 9(1), 13-24.
• Young, R., et al. (2018). Postoperative Nursing Considerations. Journal of Nursing Education, 57(4), 206-212.