Question

The client is admitted for an open reduction internal fixation of a fractured hip. Immediately following surgery, the nurse should give priority to assessing the client for: A. Hypovolemia B. Pain C. Nutritional status D. Immobilizer

Short answer

Answer: Hypovolemia

Step-by-step solution

Understand open reduction internal fixation of a fractured hip

Open reduction internal fixation (ORIF) is a surgical procedure to repair a broken hip. The surgeon aligns the fractured bones and uses metal hardware, such as plates and screws, to keep them in position while they heal.

Identify potential complications

Some possible complications immediately following ORIF surgery include blood loss, infection, nerve damage, and issues related to anesthesia. It's crucial to understand these potential risks to prioritize the most critical assessments for the client.

Evaluate the options

Now let's evaluate the four options: A. Hypovolemia: After surgery, the client may experience significant blood loss, leading to hypovolemia (low blood volume). Hypovolemia can lead to shock, organ failure, and even death, making it a crucial assessment postoperatively. B. Pain: Although pain will be a concern for the client after surgery, it is less critical than hypovolemia in terms of potential complications. Pain management is essential but is not the highest priority assessment. C. Nutritional status: Nutritional status is significant for recovery, but it is not the most crucial assessment immediately after surgery. The primary concern in the immediate postoperative period is the client's stability and potential complications. D. Immobilizer: The immobilizer helps prevent the hip from moving and supports the surgical repair. While assessing proper immobilizer function is essential, it is not as critical as other potential complications immediately following surgery.

Choose the correct answer

Based on the potential complications of ORIF surgery and the importance of each option, the priority assessment for the nurse to give immediately following surgery is: A. Hypovolemia because it can lead to severe complications such as shock, organ failure, and even death if not addressed promptly.

Key concepts

Postoperative Care

After a hip fracture surgery, like open reduction internal fixation (ORIF), postoperative care is crucial for ensuring a smooth recovery. Postoperative care involves monitoring the patient closely right after surgery to identify any complications that may arise. This includes:

• Assessing vital signs such as blood pressure, pulse, and respiration to detect any abnormalities early on.
• Monitoring the surgical site for signs of infection, such as redness, swelling, or discharge.
• Managing pain effectively to ensure the patient is comfortable, as well as able to move and participate in rehabilitation activities.
• Encouraging movement and mobility as prescribed by the healthcare team to prevent complications like blood clots.

It's important for nurses to follow protocols and collaborate with the healthcare team to address any issues promptly.

Nursing Assessment

Nursing assessment in the context of postoperative care for hip fracture surgery involves several key responsibilities. After surgery, the nurse's primary role is to conduct a comprehensive assessment to ensure the patient's stable condition. This assessment includes:

• Checking for hypovolemia by monitoring the patient's blood pressure, heart rate, and observing for signs of shock or poor perfusion, such as cool, clammy skin or confusion.
• Assessing the efficiency and security of drains or devices like an immobilizer, ensuring they're functioning properly to support healing.
• Evaluating the patient's pain levels regularly and administering prescribed pain management accordingly.
• Inspecting the surgical site regularly for any signs of excessive bleeding or infection.

Each aspect of nursing assessment helps prioritize patient safety and enhances recovery.

Surgical Complications

During the initial postoperative period following a hip fracture surgery, being vigilant about surgical complications is paramount. Several complications can arise after a procedure like ORIF, and prompt identification and management are critical. Some potential complications include:

• Hypovolemia due to blood loss during surgery. It can lead to shock if not managed swiftly.
• Infection at the incision site, which can prolong recovery and necessitate additional treatment.
• Blood clots, particularly deep vein thrombosis, due to decreased mobility.
• Nerve damage or impaired function related to the affected limb.

Understanding these complications and being prepared to intervene can significantly improve patient outcomes.

Hip Fracture Surgery

Hip fracture surgery, specifically open reduction internal fixation (ORIF), is a critical procedure for repairing hip fractures. ORIF involves realigning the fractured bones and securing them with metal plates, screws, or rods to promote proper healing. Some key considerations for this surgery include:

• Preoperative preparation, including risk assessment and informing the patient about the process and recovery expectations.
• Intraoperative care to maintain sterility and minimize blood loss.
• Postoperative care, focusing on pain management, prevention of complications, and promoting ambulation.
• Follow-up care, including physical therapy and regular monitoring to ensure proper healing and restore function.

Understanding the details of hip fracture surgery can help patients and healthcare providers work together towards the best recovery outcomes.