Case Study Chapter 28: Activity, Immobility, and Safe Movement Tara Ryan is a 75-year-old woman who has undergone a right hip replacement surgery due to an accident while walking her dog. Assessment of her vital signs indicate Mrs. Ryan has BP 164/90 which is high. She has a pain rate of 8 and has limited mobility due to pain from surgery. She has difficulty standing up to use the bathroom and is keeping herself from moving to avoid pain. Mrs. Ryan is complaining of feeling weak when she bathes or ambulates. Her hemoglobin level is low at a 10.5 g/dl. Patient is at risk of falling trying to stand up to use the bathroom. She is at risk of developing pressure ulcers due to being reluctant to move to avoid pain, and she is at risk of ischemia since she does not want to move out of bed. This patient is also at a high risk of having a psychological impact which may slow her recovery and deteriorate her health. It is important to assess her sleeping patterns and behavior changes to ensure she is not experiencing anxiety, depression, or any other behavioral problem. To prevent Mrs. Ryan from getting injured the nurse should assist her while ambulating through the halls and when using the bathroom. Assessing ROM frequently is important to prevent joint contractures due to her limited mobility. The nurse should help Mrs. Ryan perform exercises that she can tolerate to improve her mobility and encourage her to try to move frequently. Another way of preventing this patient from getting injured is always having her call bell accessible and at reach in case she needs assistance while being alone. A walker is highly recommended and having her room clear of any objects that can get in her way while walking is also a way of preventing her from falling and getting hurt. While patient is being treated her vital signs should be monitored frequently to avoid any complication since she will probably be prescribed narcotics to treat her pain. She should be assessed frequently for respiratory depression, sedation, constipation, hypotension, and confusion. Nurse should create a plan of care with interprofessional health care team to promote a good recovery. Nurse should facilitate resources for health promotion such as walkers, position bed for at home recovery, and telehealth nursing. Psychosocial resources are important to ensure patient is oriented and not experiencing any emotional problem that can lead to further complications. Ambulation support from physical therapists and social workers is another resource that should be included in the nursing plan. The nurse is responsible of educating Mrs. Ryan to move her joints frequently at least every 4 hours while awake to improve her mobility. She should take her medications as prescribed to reduce complications and avoid pain. It is important to educate patient about verbalizing her pain level and if she experiences any side effects related to pain medication. Educating patient’s family members is vital in this case since Mrs. Ryan is an elderly adult who will need assistance while recovering from her surgery. Education on how to use assistive devices and educating patient on good nutrition that can help her recover faster and properly. References Yoost, B. L., & Crawford, L. R. (2020). Chapter 28 Activity, Immobility, and Safe Movement. In Fundamentals of Nursing: Active Learning for Collaborative Practice (pp. 545–554). essay, Elsevier.