Peri-OP (Total hip-replacement) Case Study

  
The client is a 98-year-old female, admitted to the ER as a result of falling down her stairs. She has been diagnosed with rheumatoid arthritis, a fractured hip and a sprained arm. She has been moved to the ICU and will have a total hip replacement tomorrow. Lorazepam 1mg IV times one dose has been ordered. (20 points each)
• Describe the four elements of the pre-operative check list: identify the nurse’s priority assessments, diagnostics, and anticipated medical orders? Assess for pain,
 
• What potential complications does the nurse need to assess before and after giving the Lorazepam?
 If Lorazepam comes in 2mg/1ml, how many ml does the nurse need to administer?
 
• Your client is now post-op and has an order for an anticoagulant. The order is for Enoxaparin 40mg BID. Provide the rational for using this medication versus Heparin?
 
• Describe postoperative priority assessments for your client given her age, surgery and history.
 
• Discuss any nonpharmacological treatments that can be used instead of narcotic pain medications and identify if there are any contraindications given the client’s comorbidities.