Case Study 12—Jeanine Porter – 75 Year Old with a Total Hip Replacement With Answers Problem-Based Learning/Critical Thinking Ackley and Ladwig’s Nursing Diagnosis Handbook, 13th Edition Makic (2024)

Makic: Ackley and Ladwig’s Nursing Diagnosis Handbook, 13th Edition Case Studies (2024) Problem -Based Learning/Critical Thinking Case Study 12—Jeanine Porter – 75 Year Old with a Total Hip Replacement Case Scenario Jeanine Porter is a 75 -year-old woman who was admitted to the hospital after she fell at home and sustained an intracapsular fracture of the left hip at the femoral neck. She is widowed and lives with her daughter and son -in-law and their three children, ages 15, 12, and 4. She has a 50 pack -a-year smoking history and denies alcohol use. She has severe osteoarthritis of her knees and coronary artery disease (CAD). She underwent coronary artery bypass grafting (CABG) 9 months ago. Since her surgery, she has engaged in minimal exercises at home. Mrs. Porter underwent a total hip replacement. Her postoperative period was unremarkable, and she was transferred to the rehabilitation facility on her third postoperative day. She did well with her therapy and was discharged home after 10 days. Nursing Assessment At a home health visit 2 weeks after discharge, Mrs. Porter was in the living room, seated in a rocking chair. Her walker was across the room. The room smelled of smoke, and a significant amount of dust was evident on all of the furniture, as well as open bags of chips and several open soft drink cans. The floor was littered with toy trains and cars, and the sofa was full of unfolded, clean laundry. In the kitchen, the countertops and sink were loaded with dirty dishes, pots, and pans. Mrs. Porter said, “My daughter is really doing her best. I guess I am just too much for her…what with the childr en and all.” Mrs. Porter’s daughter replied, “I can handle it, I just don’t get any help from anyone, including my mother.” A. ASSESS 1. Identify the significant symptoms by underlining them in the above assessment. 2. List the symptoms (those you have underlined) that indicate the client has a health problem. 3. Group the symptoms that are similar. B. DIAGNOSE 1. Select possible nursing diagnoses for this client. Do this by looking at the list of nursing diagnoses in the book, Ackley and Ladwig’s Case Study 12-2 Nursing Diagnosis Handbook: An Evidence -Based Guide to Planning Care . Possible nursing diagnoses: 2. Validate the possible nursing diagnoses. Compare the signs and symptoms (defining characteristics) that you have identified from your client assessment with the defining characteristics for the nursing diagnosis that you have selected. Also read the definition and determine if this diagnosis fits this client. Validated nursing diagnoses include: 3. Write/select a nursing diagnostic statement for one of the nursing diagnoses by combining the nursing diagnosis label with the related to (r/t) factors. a. The label is the title of the nursing diagnosis as defined by NANDA -I. Include the Domain and Class. b. An r/t statement describes the factors that may be contributing to or causing the problem that resulted in the nursing diagnosis. NANDA -I label: Related Factors (r/t): The complete nursing diagnostic statement is: C. PLAN 1. Select appropriate NOC outcome from the Ackley/Ladwig text. NOC outcome: Fill out the grid with NOC indicators and the appropriate Likert scale. Select the appropriate point on the Likert scale to measure the client’s current status. INDICATOR 2. Or write outcomes to help resolve the symptoms (defining characteristics). Refer to Section III of the Ackley/Ladwig text for the nursing diagnosis care plan. Outcomes: