MR O’BRIEN FALL CASE STUDY
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
Mr. O’Brien
GENDER Male
AGE 81
SETTING Hospital
ETHNICITY White American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITIONS
Atrial fibrillation (AFib); syncope; peripheral vascular disease (PVD)
COEXISTING CONDITION Hypotension
COMMUNICATION
DISABILITY Ambulates with a walker and one assist
SOCIOECONOMIC
Resides in a long-term nursing care facility; financial and social implications of fall-related injuries
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
Oxycodone/acetaminophen 5/325 (Percocet)
LEGAL
Fall precautions; incident report (occurrence or variance report); restraints
ETHICAL
ALTERNATIVE THERAPY
PRIORITIZATION
DELEGATION
Nursing assistant’s role
Overview: This case requires the nurse to identify appropriate interventions upon learning that a client has fallen. The nurse is asked to discuss fall precautions and proper documentation of a client safety incident. The use of a restraint is considered. The nurse must also assess the client for orthostatic (postural) hypotension. The incidence of falls, injuries resulting, fall-related deaths, financial and social implications, and need for long-term care following a fall are reviewed.
Client Profile
Mr. O’Brien is an alert and oriented 81-year-old man admitted to the hospital with complaints of dizziness and syncope. His blood pressure (BP) on admission is 80/43. At the long-term nursing care facility where he lives, he ambulated with a walker independently but, since his episode of syncope, he has complained of weakness and needs another person to assist while walking as a fall precaution.
Case Study
Mr. O’Brien is admitted with prescriptions that include assessment of orthostatic vital signs every shift and fall precautions. The nurse explains to Mr. O’Brien how to use the call light and instructs him to call before getting out of bed so that someone can assist him with ambulation. The nurse completes a set of orthostatic vital signs. His orthostatic vital signs are lying: BP 5 120/84, heart rate (HR) 5 73; sitting: BP 5 114/73, HR 5 83; standing: BP 5 96/61, HR 5 92. When the assessment of orthostatics is complete, Mr. O’Brien is settled in bed. The nurse raises two side rails at the head of the bed, and the bed alarm is turned on so that if Mr. O’Brien tries to get out of bed without assistance, an alarm will notify staff.
Later in the shift, Mr. O’Brien’s bed alarm sounds. The nurse quickly goes to his room to find Mr. O’Brien lying on the floor on his right hip. He is alert and oriented and states, “I had to go to the bathroom. I know I should have called for help but the nurses are busy. I figured I could go myself. Only two more steps and I could have reached my walker. I just slipped is all.” Immediately following his fall, Mr. O’Brien complains of pain in his right hip that is a “7” on a 0–10 pain scale. He describes the pain as a “dull ache” that is worse with movement of his right leg. His BP is 110/62, HR is 88, and respiratory rate (RR) is 16.
Questions
- Which clients are at greatest risk for falls in the acute care setting? Consider physiological and environmental risk factors for falls.
- Identify seven areas of a fall risk assessment.
- Discuss the initial nursing interventions when the nurse enters Mr. O’Brien’s room and finds him lying on the floor.
Discuss who should be notified about
- O’Brien’s fall and what type of documentation is needed regarding the incident.
- What test(s) will the health care provider most likely prescribe because Mr. O’Brien is complaining of pain in his right hip?
- The nurse double checks to see that appropriate fall precautions are in place. Identify ten measures to help prevent falls in older adults.
- What can the nursing assistant do to help in maintaining Mr. O’Brien’s safety?
- The nurse must complete an incident report. Discuss the purpose of an incident report and list the elements/type of data to address when completing this report.
- O’Brien was assisted back to bed with a Hoyer lift and two assists. His vital signs remained within his baseline throughout the remainder of the shift and he is afebrile. An X-ray of his right hip was negative for a fracture. There is no physical deformity of the right hip or other injuries apparent, but a moderate amount of ecchymosis of his right hip that extends around to his lower back and right upper buttock is noted. His health care provider, Dr. Sutton, prescribed one tablet of oxycodone/acetaminophen 5/325 by mouth (PO) that decreased Mr. O’Brien’s pain to a “2/10” within forty minutes of administration. He remains alert and oriented, continues on bed rest, and used the urinal once for 200 mL of clear yellow urine. The bed alarm is on, the call bell is in reach, and there are two side rails up. Mr. O’Brien has verbalized an understand-ing of how and when to use the call bell. Write a nursing progress note regarding the fall to enter into Mr. O’Brien’s chart. Use the S.O.A.P.I.E. or Focus/ D.A.R. method for writing a nursing note.
- Provide a brief explanation of what orthostatic (postural) hypotension is and identify the blood pressure and heart rate values that define orthostatic (postural) hypotension.
- Explain the steps of assessing orthostatic vital signs. From a lying to standing position, is Mr. O’Brien exhibiting signs of orthostatic hypotension based on the vital signs the nurse collected?
- Identify Mr. O’Brien’s predisposing risk factors for a fall.
- The use of a vest restraint could be considered for Mr. O’Brien to prevent another fall. Define a restraint and provide examples of physical restraints and chemical restraints.
- Discuss the risk of client injury associated with the use of restraints and the prescription requirements to implement restraints.
- Identify five alternatives to using restraints.
Briefly address the following:
(a) What is the incidence of falls and fall-related deaths in the older adult population?
(b) Is there a difference in the incidence and mortality between men and women? If so, explain.
(c) What are the common injuries that result from a fall?
(d) What are the potential social implications for the older adult who has suffered a fall?
(e) Describe the need for long-term care following a fall.
- The most common fracture resulting from a fall is a hip fracture. Discuss the incidence of and mortality associated with a hip fracture, as well as the difference in the incidence of hip fractures between men and women.
- What is a “HipSaver”?
- Write an appropriate three-part nursing diagnosis to include in Mr. O’Brien’s plan of care regarding his fall.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. They can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally, the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
CLICK ON THE LINK HERE: https://www.perfectacademic.com/orders/ordernow
Also, you can place the order at www.collegepaper.us/orders/ordernow / www.phdwriters.us/orders/ordernow
Do You Have Any Other Essay/Assignment/Class Project/Homework Related to this? Click Here Now [CLICK ME]and Have It Done by Our PhD Qualified Writers!!