Underlying Pathology and Admission to Emergency Department - Case Study Example

? Case Study Introduction During my last placement in Emergency Department- ED, I had the opportunity to look after various patients, some that required minimal assistance and others with full nursing care due to their complex conditions. However, one patient I found very interested was Mrs S, a ninety one years old female admitted to the hospital with a dislocated left prosthetic hip. Mrs S is widowed and has been leaving in aged care for the past eleven years. She has one daughter and one grandchild who are in attendance. Her medical history includes falls, dislocated left prosthetic hip, chronic atrial fibrillation, osteoarthritis, breast cancer-Left mastectomy, Right knee replacement and macular degeneration, dementia, bilateral total hip replacement. Underlying pathology and admission to ED Mrs. S was admitted to the hospital post fall, from bed to floor, complaining of severe pain on her left leg. She got unable to stand or bend due to her left leg. From her past history, Mrs. S became placed on a five leads cardiac monitor and her blood samples got taken. Her chest, pelvis and left hip x-ray got organised. The results obtained indicated her chest x-ray as clear, but with complete dislocation of the femoral prosthesis from the acetabular cup. Multiple dislodge metallic wiring also got noted. She then got diagnosed as having a dislocated left prosthetic hip which was reduced by gentle traction in ED. Goals of treatment The goals of treating Mrs S dislocated left prosthetic hip got set as; relieving her from pain, help her hip joint work better, and improving her walking and other movements (Kneale & Davis, 2005). Like other patients who suffer from hip dislocation, Mrs S undergoes groin and hip pain. Her pain emanates from her complete dislocation of her femoral prostheses from the acetabular cup. The treatment intends to reduce and control the pain. It is vital that Mrs S got provided with pain medication. Once this goal becomes achieved, the patient can undergo the rest of the medication process in a relaxed state. Another aim of her treatment was to get Mrs S left prosthetic hip to work better. Through gentle traction, Mrs S left hip prostheses should get back to its anatomical position in the acetabular. Once this repositioning gets achieved, Mrs S hip would get back to perform its range of muscular movement operations. The treatment focuses on stretching and strengthening the muscles that surround the hip joint. This allows the hip to gain back its strength and motion. When repositioning of the dislocated left hip prosthesis gets achieved, Mrs S should get to improve her walking and other movements. The goal of the treatment is to allow Mrs S to participate in activities such as walking. Increasing the patient’s mobility will allow her to live a more fulfilling life. The aforementioned treatment goals for Mrs S got achieved through providence of pain medication and gentle traction (Kneale & Davis, 2005). After evaluation of her pain, Mrs S got administered with sufficient analgesia. While at the ED, the patient got administered with intravenous morphine to relieve her off her pain. To improve her mobility and relocate her dislocated prosthesis, gentle traction of the leg with mild sedation helped to achieve the goals (Valle, 2010). Role of technology The first technology employed in the treatment of Mrs S was the 5 lead cardiac monitor. The cardiac monitor got used as part of the patient’s physical examination tests (Marx et al, 2010). This monitor got used to test and check for problems with the electrical activity of the patient’s heart. This monitor translates the hearts electrical activity into waves on a paper. The 5 lead cardiac monitor got used in the treatment of the patient to check if her heart’s electrical activity was okay. The monitor helps to indicate whether the electrical impulse within the heart gets conducted normally. The use of X ray technology on Mrs S’s chest, pelvis and left hip assists to provide the internal structure of these parts of the body. The X rays help to provide a visual image of the interior structure of a patient’s body (Anastasio & Riviere, 2012). The X rays provide the physicians with the images/radiographs of the body parts under observation. The X ray conducted on the patient’s chest assists the doctors in uncovering the interior structure of the heart, lungs, ribs, and diaphragm. The X ray assisted the doctors to determine if there was any abnormalities in the body parts mentioned. The X ray on her left hip guided the doctors in relocating her dislocated left hip prosthesis. The X ray of the patient’s left hip assisted the doctors in conducting traction on the patient’s leg. Another technology that got used in the treatment of Mrs S was the Computerised Tomography scan- CT scan. This technology got to create detailed images of the inside of Mrs S’s body. The use of the CT scan on Mrs S produced tomograms that were further detailed than the earlier radiographs produced by the standard X rays. The CT scan helped to provide the physician with the images of Mrs S internal structures such as her body organs, bones, tumours, and blood vessels (Anastasio & Riviero, 2012).. The use of the CT scan in this case was to diagnose and monitor the patient’s hip condition after dislocating her prosthesis. The CT scan provided a detailed picture of the patient’s bone condition. The use of the CT scan also assists the physician’s to determine on how to proceed with the patient’s treatment in regard to images obtained from her dislocated hip. Assessment of the Effectiveness of patient’s treatment Assessment of the patient’s improvement or response to treatment gets conducted through physical observation and the patient’s perception about the treatment. Immediate assessment of the patient’s response to treatment got observed through her experiencing of less pain upon the commencement of treatment. Continued physical examination of the patient also assists to provide an assessment of the patient’s response to treatment (Correll, 2012). The physical examination involves undertaking daily monitoring of the patient’s symptoms as experienced by her. The physicians get to record the daily changes witnessed by the patient in assessing her response to treatment. The patient’s family also assist the physicians with any information they receive from their patient about the treatment or her current condition on how she is feeling (Curtis & Ramsden, 2011). Continued regular assessment of X rays and scans on the dislocated hip also assists the physicians to understand the patient’s response to treatment. The X rays and scans after the treatment should indicate the relocation or repositioning of the prosthesis in its correct anatomical position. The scans and X rays assist in the observation of treatment results on the patient. For the time I cared for Mrs S, she showed signs of steady improvement. This got attributed to the analgesic medication she got to receive at the hospital, which assisted greatly in relieving her off pain (Holland, 2012). The traction performed on her left leg helped to relocate her prosthesis into its right anatomical position. The traction assisted in strengthening her hip joint area and muscles better. Mrs S steady improvement also resulted from the medical attention provided by the hospital staff in charge of her. She received professional and great medical attention as pertains to her needs. Conclusion Mrs S got admitted to the ED as a result of a dislocated left prosthetic hip. Her treatment plan aimed at restoring Mrs S mobility, relieving her off her pain, and relocating her dislocated left prosthesis hip. These goals of the treatment plan got achieved through administration of analgesic medication and performing gentle traction on her affected body part. Several technologies got employed in Mrs S treatment; the 5 lead cardiac monitor, the CT scan, and the X ray. Assessment of the patient’s response to treatment got conducted by physical examination and observation of the patient. Further results from scans and X rays also helped to assess the patient’s treatment. References Correll, D. (2012). Nurse Practitioner Acute Care Protocols - Second Edition: For Emergency Departments, Urgent Care Centers, and Family Practices. New York: Acute Care Horizons, LLC, . Holland, K. (2012). Nurse Education in Practice. Elsevier , 1-10. John A. Marx, R. S. (2010). Rosen's Emergency Medicine - Concepts and Clinical Practice. New York: Elsevier. Julia D. Kneale, P. S. (2005). Orthopaedic and trauma nursing. London: Churchill Livingstone. Kate Curtis, C. R. (2011). Emergency and Trauma Care for Nurses and Paramedics. Sydney: Elsevier Health Sciences. Mark A. Anastasio, P. L. (2012). Emerging Imaging Technologies in Medicine. New York: CRC Press. Valle, A. G. (2010). Instructions to Prevent Dislocations. Dislocations, 1-2. Read More