CONCEPT MAP WORKSHEET
DESCRIBE DISEASE PROCESS AFFECTING PATIENT
(INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
Hip fracture (Intertrochanteric)
-Breaks of the femur between the greater and lesser trochanters.
-It is caused by severe trauma like falls, car accidents, and weak bones. Hip fractures increase with age
because older adults are unsteady when ambulating and are at a high risk of falling.
Osteoporosis
-A bone disease that makes bones weaker and easier to brake from falls or minor bumps like sneezing.
-It is the deterioration in bone tissue which increases the risk for fracture bones.
DIAGNOSTIC TESTS PATIENT INFORMATION ANTICIPATED PHYSICAL FINDINGS
(REASON FOR TEST AND
RESULTS)
-x-ray: shows location of fracture Edith Jacobson is an 85- -Displacement of the left hip.
and is used to determine the year-old white female who
surgical intervention that is needed. after falling has fractured -Limited range of motion.
-BMP: blood work that shows her left intertrochanteric
levels of BUN, CA, K, glucose, and hip. Mrs. Jacobson has a -Inability to move or bear
creatine.
10-year history of weight on affected limb.
-CBC without differential.
osteoporosis.
-Prothrombin time: shows result of
-One leg will look shorter
coagulation time.
-EKG: shows the electrical compared to the other leg.
impulses of the heart
ANTICIPATED NURSING
INTERVENTIONS
-Reposition the patient as frequently as possible.
-Maintain proper body alignment.
-Maintain bedrest.
-Support fracture site with pillows or folded blankets.
-Frequently assess patients skin for skin integrity.
-Educate patient on fall risk and patient safety.
-Maintain patient safety from falls by making sure room is uncluttered, light is present so the
patient can see where they are going, bed is in the lowest position possible, and call bell is within
reach.
, vSim ISBAR ACTIVITY STUDENT WORKSHEET
INTRODUCTION Barbara Gonzalez
Nursing student
Your name, positon (RN), unit you are Orthopedic Unit 1555
working on
SITUATION Edith Jacobson
85-year-old
Patent’s name, age, specific reason for visit White Female
Admitted with a left intertrochanteric hip fracture
BACKGROUND Dx: left hip fracture and a history of Osteoporosis
Admitted on 03/08/2021
Patent’s primary diagnosis, date of Current orders:
admission, current orders for patent -Vital signs every 4 hours
-Activity: bedrest
-Antiembolism stockings on both legs
-NPO after midnight the night before surgery
-Lactated Ringer’s solution at 84 mL/hr IV. Start at 2100 the night
before surgery
Medications:
- Docusate sodium 100 mg orally daily
-Enoxaparin sodium 40 mg subcutaneously daily
-Morphine sulfate 4 mg IV every 4 hours prn for pain
ASSESSMENT Mrs. Jacobson reports pain to be a 2 on a scale of 1-10. Patient is alert
and oriented. Patient has no known allergies. Vital signs: BP 138/82,
Current pertnent assessment data using head Pulse 90, SpO2 97% (room air), Temp. 99 F, and Resp. 15 bpm. There
to toe approach, pertnent diagnostcs, vital is tenderness in the patients left hip area and the patients left leg is a bit
shorter than the right leg. Lungs are equally bilateral and clear. Heart
signs
rate is normal. Bowel sounds were normal. Patients strength is normal
in her upper extremities. There is normal sensation in all limbs.
Patients IV site has no redness, swelling, infiltration or drainage, and
dressing is intact. Patient was repositioned with help from another
nurse from a supine position to her right side.
RECOMMENDATION Patient is to be repositioned every 4 hours (call second nurse to help).
Patient should be assessed for pain prior to repositioning. If patients
Any orders or recommendatons you may have pain level elevates administer scheduled prn morphine.
for this patent
DESCRIBE DISEASE PROCESS AFFECTING PATIENT
(INCLUDE PATHOPHYSIOLOGY OF DISEASE PROCESS)
Hip fracture (Intertrochanteric)
-Breaks of the femur between the greater and lesser trochanters.
-It is caused by severe trauma like falls, car accidents, and weak bones. Hip fractures increase with age
because older adults are unsteady when ambulating and are at a high risk of falling.
Osteoporosis
-A bone disease that makes bones weaker and easier to brake from falls or minor bumps like sneezing.
-It is the deterioration in bone tissue which increases the risk for fracture bones.
DIAGNOSTIC TESTS PATIENT INFORMATION ANTICIPATED PHYSICAL FINDINGS
(REASON FOR TEST AND
RESULTS)
-x-ray: shows location of fracture Edith Jacobson is an 85- -Displacement of the left hip.
and is used to determine the year-old white female who
surgical intervention that is needed. after falling has fractured -Limited range of motion.
-BMP: blood work that shows her left intertrochanteric
levels of BUN, CA, K, glucose, and hip. Mrs. Jacobson has a -Inability to move or bear
creatine.
10-year history of weight on affected limb.
-CBC without differential.
osteoporosis.
-Prothrombin time: shows result of
-One leg will look shorter
coagulation time.
-EKG: shows the electrical compared to the other leg.
impulses of the heart
ANTICIPATED NURSING
INTERVENTIONS
-Reposition the patient as frequently as possible.
-Maintain proper body alignment.
-Maintain bedrest.
-Support fracture site with pillows or folded blankets.
-Frequently assess patients skin for skin integrity.
-Educate patient on fall risk and patient safety.
-Maintain patient safety from falls by making sure room is uncluttered, light is present so the
patient can see where they are going, bed is in the lowest position possible, and call bell is within
reach.
, vSim ISBAR ACTIVITY STUDENT WORKSHEET
INTRODUCTION Barbara Gonzalez
Nursing student
Your name, positon (RN), unit you are Orthopedic Unit 1555
working on
SITUATION Edith Jacobson
85-year-old
Patent’s name, age, specific reason for visit White Female
Admitted with a left intertrochanteric hip fracture
BACKGROUND Dx: left hip fracture and a history of Osteoporosis
Admitted on 03/08/2021
Patent’s primary diagnosis, date of Current orders:
admission, current orders for patent -Vital signs every 4 hours
-Activity: bedrest
-Antiembolism stockings on both legs
-NPO after midnight the night before surgery
-Lactated Ringer’s solution at 84 mL/hr IV. Start at 2100 the night
before surgery
Medications:
- Docusate sodium 100 mg orally daily
-Enoxaparin sodium 40 mg subcutaneously daily
-Morphine sulfate 4 mg IV every 4 hours prn for pain
ASSESSMENT Mrs. Jacobson reports pain to be a 2 on a scale of 1-10. Patient is alert
and oriented. Patient has no known allergies. Vital signs: BP 138/82,
Current pertnent assessment data using head Pulse 90, SpO2 97% (room air), Temp. 99 F, and Resp. 15 bpm. There
to toe approach, pertnent diagnostcs, vital is tenderness in the patients left hip area and the patients left leg is a bit
shorter than the right leg. Lungs are equally bilateral and clear. Heart
signs
rate is normal. Bowel sounds were normal. Patients strength is normal
in her upper extremities. There is normal sensation in all limbs.
Patients IV site has no redness, swelling, infiltration or drainage, and
dressing is intact. Patient was repositioned with help from another
nurse from a supine position to her right side.
RECOMMENDATION Patient is to be repositioned every 4 hours (call second nurse to help).
Patient should be assessed for pain prior to repositioning. If patients
Any orders or recommendatons you may have pain level elevates administer scheduled prn morphine.
for this patent
