IBAY, MARK ANTHONY LABASAN, LEIGH ANDREA LASTIMA, CRYSTAL GAYLE LOGAN, JANINE PERSONAL DATA Name: Mrs.

Bear Address: Brgy. Dopaj, Dupax del Sur, Nueva Vizcaya Birthday: November 27, 1932 Age: 80 years old Civil Status: widowed Educational attainment: High school undergraduate (2nd year high school) Nationality: Filipino Religion: Roman Catholic Language: Ilocano Occupation: Buy and sell (rice and charcoal) HISTORY OF PRESENT ILLNESS Mrs.Bear, an 80 year old woman, was hospitalized 2 years ago due to mild stroke. According to her, a day prior to her admission, she woke up at night when suddenly her right side body sagged and her tongue protruded. She was rushed by her youngest child in Dupax District Hospital and was referred in Danguilan clinic. During her admission, she had a BP of 200/120 mmhg and had a diagnosis of mild stroke. She was hospitalized for a week and had her 2 months therapy for her fast recovery. She had her maintenance medications namely, Hanbas, Aspirin and Teroblock. She also goes to Danguilan clinic every month for her check-up. After the recovery, last year, while she was walking, she suddenly slipped on the rough road. She felt pain on her left hip and cannot stand so she was rushed in Danguilan clinic. According to her doctor, he had a left hip fracture and will no longer need an operation due to her age and to prevent further complications. She was just given pain reliever and provided a walker by her children to assist in ambulating. They also hire a nanny to assist her in her daily activities. HISTORY OF PAST ILLNESS Aside from common colds and cough, Mrs. Bear has no other illnesses. She did not undergo vaccination because there was no vaccination before. She also stated that she has no vices. She doesnt have any idea of her parents deaths history because according to her, they are just relying their health in a quack doctor. Mrs.Bear is already widowed and has 8 children. According to her, her husband was a chain smoker. She ws fond of eating salty and oily foods way back then but switched to vegetables when she was diagnosed of a mild stroke.

ASSESSMENT Left hip fracture Functional level: 3- requires help from another person and equipment device Complaint of pain and difficulty in walking by patient 4/5 4/5 4/5 3/5

PATHOPHYSIOLOGICAL BASIS Trauma to the left hip Musculoskeletal impairment Pain Impaired physical mobility

INTERVENTION Assess degree of pain and listening to clients description Encourage patient to have adequate rest periods during the day to reduce fatigue. Provide for safety measures as indicated by individual situations. EXAMPLE: Always maintain a dry floor inside the house to prevent from injury. Encourage S.O. in always assisting patient in doing ADLS and in using assistive devices. Encourage adequate intake of fluids and nutritious foods to promote well being and maximize energy production. Assess for referred pain to help determine possibility of underlying condition. Encourage verbalization of feelings about pain. Encourage use of relaxation techniques to distract attention and reduce tension. Encourage adequate rest periods to prevent fatigue. Discuss with S.O. ways in they can assist client and reduce precipitating factors that may cause or increase pain

Sumasakit yung kaliwang balakang ko pag naglalakad avb the patient Pain scale: 4/10 Use of pain reliever

Trauma Muscle injury Inflammatory response Release of chemical mediator Stimulation of nociceptor sites Transmission of nerve impulses to brain Perception of pain

ADLs with minimal assistance Feeding- inability to prepare food Bathing- inability to wash body parts; inability to get in and out of bathroom Toileting- inability to sit and stand from toilet bowl without assistance

Trauma to the left hip Musculoskeletal impairment Pain Impaired physical mobility Self care deficit

Identify energy saving behaviours. Example: sitting instead of standing Encourage food and fluid choices reflecting individuals likes and abilities that meet nutritional needs. Review safety concerns in modifying activities/ environment to reduce risk of injury Provide privacy during personal care activities Provide for communication among those who are involved in caring for or assisting the patient to enhance coordination and continuity of care. Instruct to increase fiber reached food and bulk in the diet to improve consistency of food and facilitate passage then through colon Instruct to have adequate fluid intake including high fiber juices to promote moist/soft stool. Encourage activity/exercise within the limit of individuals ability to stimulate contraction Discuss rationale and encourage continuation of successful intervention

Defectaing 3x a week Madication: Dulcolax 2x a month Passage of hard and dry stool avb the patient.

Hip fracture and aging Decrease mobility Lack of exercise Decrease metabolism constipation

Left hip fracture Blurred vision Age:80 years old

Aging, musculoskeletal impairment, blurred vision Risk for injury

Instruct client/S.O. to request assistance as needed Instruct patient/SO to have adequate lighting inside the house Ensure that pathway in house is unobstructed and properly lighted Maintain bed/chair in a low position Remind to have/maintain dry floor to prevent patient from injury.