Care of the person with an acute illness, CAP203

Subject name and code: Care of the person with an acute illness, CAP203

Assessment number:1

Student name: Briste Basnet

Student number: A00081265

Word count: 658

Assessment of the risk factors contributing to the fracture neck of the femur

Maria is 76 years old woman admitted to the emergency department with a history of falls. She has a medical history of glaucoma, and osteoporosis and has recently been diagnosed with dementia. Currently, she takes Aspirin, alendronate sodium, and latanoprost. The study shows that the major risk factor for fracture is age i.e., women of age 50-65 years old and above are diagnosed with osteoporosis (Martnez-Laguna, 2022). As evidenced by the x-ray film, Maria fractured her intertrochanteric region of the right femur. Similarly, the signs of shortened right leg and extremely rotated, even suggest that Maria has a fractured neck of the femur.

Pathophysiology of osteoporosis and increased risk of fracture

Osteoporosis is due to the deterioration of the bone tissue and decreased bone mass with an increased chance of fracture. In the case of Maria, she is a post-menopausal woman which also contributes to reduction in bone mass density called osteoporosis which results in a fracture (Ji, 2015).

Identified priorities in the pre-operative period.

History of the complaint: Maria has a fall history, and she was found 3 hours after the fall. The co-morbidities Maria has been dealing with are osteoporosis, glaucoma, and dementia. These conditions need to be identified before the surgery to prevent the risk of anesthesia.

Blood Tests: Full blood count helps in identifying thrombocytopenia, and anemia as this helps in reducing the risk of cardiovascular diseases and prepares in arranging the blood products. Maria is taking aspirin which is related to a raised risk of heavy bleeding (Estcourt, 2018).

Cardiac investigations: Age is related to heart malfunctions which should be assured with the echocardiogram or ECG (National Institute on Aging, n.d). The risk related to the circulatory systems can be identified which needs to be tailored at the time of the pre-operative period.

Urinalysis: The incidence of urinary tract infection is high among aged and menopausal women (Olsson, 2020). The evidence of urinary tract infection needs to be assessed before conducting the surgical procedure to reduce the chance of sepsis.

Assessing the functional capacity of the patient: The operative procedure can be improved by assessing the functional capacity, as it is linked with lowering the risk of severe complications. Poor functional capacity is regarded as the independent predictor of post-operative diseases (Minnella, 2019).

Legal and ethical considerations on consent and maintaining privacy and confidentiality.

Maria needs to be aware of adequate information about the procedures and consequences of the surgery before obtaining consent. The ethical challenges while obtaining consent because of use of the medical jargon words, unclear language, lack of time, unclear information, lack of understanding level of the patient, and failure in providing adequate information (Moeini, 2020). Thus, for clarity, assurance must be made with Maria from here the consent can be obtained. Confidentiality and privacy need to be attended to by maintaining the register consisting of the health information, and requirements for the HIPAA (Health Insurance Portability and Accountability Act) and privacy rule. The confidentiality and privacy of patients like Maria is recognized and established by state and federal agencies, and laws. The confidential information of Maria which includes medical and professional records is guarded to secure standard protective orders. If the confidentiality or privacy of Maria is violated, then one is charged with penalties and is recorded as criminal activities. The confidentiality regarding Marias treatment protocols needs to be protected and should be kept private (Kundlani, 2020).

Problems of the patient in the pre-operative room

Maria is driven to the emergency department because of the accident which had led to the intertrochanteric fracture. Because of the fracture, Maria is having pain that scored 5/10 on rest and 7/10 while moving. As per the data provided, the blood sugar is reported high (Normal-4-7 mmol/l) (CDC, 2023). Since she requires surgery to fix the fracture, she is worried and stressed about not being able to water the plants.