Nursing Care For Hip Arthroplasty Due To Fracture Neck Of Femur In Patient With Hypertension And Diabetes Mellitus

Abstract

This case study aimed to compare the nursing care for hip arthroplasty due to fracture neck of femur in patient with hypertension and diabetes mellitus; 2 case study. The population included 2 inpatients receiving treatment in the female orthopedics ward at Ratchaburi Hospital, Ratchaburi Province, during 1 – 30 September, 2020. The samples were obtained by purposive sampling. Both of 2 case studies were a 74- and 81-year-old female patient with hypertension and diabetic mellitus, came to the hospital with slipping and left hip pain. The doctor diagnosed it as a fracture of the left cervical femur. The instruments used in the study included the record form, and interview. Content analysis was used for data analysis. The results revealed that both case studies were the older adults, coming with the same accident and non-severe injury. They received hip arthroplasty. Case Study 1 received aspirin and was instructed by the physician to stop taking it. She could receive surgery in 6 days. However, Case Study 2 had hyponatremia and must be remedied first, causing delayed surgery. The complications occurred due to long sleep, i.e., urinary tract infection (UTI) and constipation. Therefore, extra treatment was required. She received surgery after 24-day admission, causing longer length of stay and higher medical expenses. Rehabilitation and preparation for discharge increased confidence of patients and their relatives. Both case studies had been prepared since their first receipt, with periodical review. According to the follow-up after discharge, neither dislocation of artificial hip joint nor recurrent falls/slipping was found. The combination of nursing process, medical treatment, and interdisciplinary cooperation was necessary for patient care before, during, and after surgery; rehabilitation, and preparation for discharge. It brought safety for patients and less worries for patients and their relatives. Patients could turn to live their quality life