Mr. Jones is an 80-year-old man who lives in his apartment in a large city. His wife passed away five years ago from cancer, and his adult children live in other states; the closest is a son who lives six hours away by car. Mr. Jones has kept himself quite active since his wife passed away. He goes to the senior center three or four times a week, meets up with some male friends for coffee almost every morning, and on Friday nights, goes to the bingo hall to play some games. He does have someone come in to help with housework and laundry.

Last week, Mr. Jones was leaving his apartment building when a neighbor’s small dog got loose, with the leash trailing behind it. The dog went to jump up on Mr. Jones, and in the process, Mr. Jones became tangled in the leash and fell hard on his right side. He was in significant pain, and his right leg was at an odd angle. An ambulance was called to take him to the hospital. X-rays were ordered for his leg and hip, revealing a fracture in the tibia at the head with some bone displacement and a fracture in the femoral head. Mr. Jones underwent surgery to place a plate and screws to correct the tibia fracture and additional surgery to address the fracture in the femoral head.

You are the nurse assigned to Mr. Jones upon his admission to the unit after surgery. He is complaining of pain rated at 9/10 and does not want to move. He is restricted in the range of motion for the femur repair and has a splint on his leg for the tibia fracture.

1. What are your concerns as a nurse about the mobility of this client?
2. What assistance will he require from the nursing team to provide ADLs (Activities of Daily Living) and personal hygiene?
3. What are your recommendations for assistive mobility devices for this client?
4. What vital sign changes could you anticipate due to his mobility restrictions?

Mr. Jones' mobility concerns include preventing pneumonia, DVT, and pressure sores. He will need assistance with ADLs and personal hygiene, and a walker or wheelchair is recommended for mobility. Anticipated changes in vital signs include increased heart rate and blood pressure due to pain and immobility.

Nursing Concerns for Mr. Jones’ Mobility

As Mr. Jones' nurse, your primary concerns regarding his mobility include preventing complications such as pneumonia, deep vein thrombosis (DVT), and pressure sores due to immobility. Close monitoring of his pain levels and ensuring proper pain management is essential to facilitate any necessary movement and prevent further complications.

Assistance Required for ADLs and Personal Hygiene

Mr. Jones will require assistance with activities of daily living (ADLs) such as bathing, dressing, and toileting. Due to his fractures, he will need help with personal hygiene tasks, especially those requiring bending or standing, to avoid putting additional strain on his injuries.

Recommendations for Assistive Mobility Devices

For Mr. Jones, the recommended mobility devices would include a walker with wheels or a wheelchair to assist with movement while keeping his weight off the injured leg. Utilizing these devices will aid in preventing falls and promoting his independence as he recovers.

Anticipated Vital Sign Changes

Due to Mr. Jones' restricted mobility, you may anticipate changes in his vital signs such as an increased heart rate and blood pressure due to pain and decreased mobility. Monitoring for signs of respiratory issues and blood clots is also crucial in identifying potential complications early.