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Pre-op F.J. is a 70-year-old white woman

Pre-op F.J. is a 70-year-old white woman admitted to the hospital because of a fall at home during the night. She is scheduled for an open reduction with internal fixation (ORIF) of the right hip at 8:00 AM this morning. She has a history of type 2 diabetes mellitus that is well managed with metformin 5 mg twice daily. Subjective Data States pain is a level 7 on a scale of 0 to 10 the Last dose of metformin was at 6:00 PM the previous evening Objective Data Physical Examination Blood pressure 120/54, pulse 101, temperature 98° F, respirations 20 Alert and oriented to person, place, and time Lungs clear to auscultation Heart rate and rhythm regular, no murmurs Height 5’2″, weight 150 pounds Bowel sounds active and present in all four quadrants Circulation and sensation to bilateral lower extremities intact Strength left lower extremity 5/5, right lower extremities not tested because of pain Diagnostic Studies X-ray reveals a break in the right hip Morning blood glucose level was 280 mg/dL Interprofessional Care Preoperative Orders NPO after midnight Type and crossmatch 2 units of packed red blood cells Start an IV of Lactated Ringer’s at 75 mL/hr Place in 5 lbs. Buck’s traction Ensure that the surgical consent form is signed and placed in the chart Administer ceftriaxone sodium 1 gram IV when called to OR Answer the discussion questions below. What is the rationale for F.J. being NPO after midnight? What preoperative teaching should you provide to F.J.? What conditions must be met for F.J. to provide consent for surgery? What risks exist for F. J. as she undergoes surgery? What is the significance of F.J.’s glucose level and how will it affect F.J.’s care? What are your priority actions as F.J. awaits surgery?

 
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