A nurse in a long-term care facility has received change-of-shift report about four clients. Which of the following clients should the nurse attend to first?
A.
A client who has heart failure and is incontinent of urine
B.
A client who has COPD and dementia and was agitated during the night shift
C.
A client who had a hip arthroplasty 10 days ago and reports pain with ambulation
D.
A client who had a cerebrovascular accident 6 months ago and reports constipation
The Correct Answer and Explanation is :
In the given scenario, the nurse should prioritize attending to the client who had a hip arthroplasty 10 days ago and reports pain with ambulation (Option C).
Rationale:
1. Postoperative Pain and Mobility Concerns:
- The client who had a hip arthroplasty 10 days ago and reports pain with ambulation is experiencing postoperative pain, which could indicate several potential issues. Pain after a hip arthroplasty, particularly when ambulating, could suggest complications such as improper alignment of the prosthesis, infection, or even complications like deep vein thrombosis (DVT).
- Effective management of postoperative pain is crucial for proper recovery and mobility. Pain can hinder the client’s ability to participate in necessary physical therapy and rehabilitation, which are essential for optimal recovery and function. Therefore, addressing pain management promptly is essential to prevent long-term mobility issues and complications.
2. Comparison with Other Clients:
- Client with Heart Failure and Urinary Incontinence (Option A): While this client may have significant needs, urinary incontinence in itself is not as immediately life-threatening or urgent compared to potential complications following a recent surgical procedure. Addressing incontinence can often be managed through regular toileting schedules and use of incontinence products.
- Client with COPD and Dementia (Option B): Agitation in clients with COPD and dementia can be concerning, especially if it indicates an underlying issue such as respiratory distress or acute confusion. However, the immediate risk in this case would likely be related to respiratory function, which may not be as urgent as assessing and managing postoperative pain that could impact recovery.
- Client with Cerebrovascular Accident and Constipation (Option D): Constipation in a client who had a cerebrovascular accident (CVA) is an important issue to address, especially to prevent complications like bowel obstruction or discomfort. However, this issue typically develops over a longer period and is less immediate compared to the acute need for managing postoperative pain and potential complications.
In conclusion, addressing the client with postoperative pain (Option C) should be the nurse’s priority due to the potential for serious complications impacting recovery and mobility. Immediate assessment and management of this client’s pain are crucial for optimal recovery and prevention of additional complications.