Joint Replacement Center Johnson City

 

 

The Joint Replacement Center at
Johnson City Medical Center
Hip Fracture - Preventing Potential Complications


Recognizing and Preventing Potential Complications

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What You Should Know About Confusion While in the Hospital

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Confusion is the inability to think with usual speed or clarity. It is also characterized by difficulty focusing and feeling disoriented. It is not uncommon for some people to become confused during their hospital stay. The following things may increase the risk for confusion:

  • Major surgery with anesthesia
  • Decreased level of oxygen in the blood
  • Excessive alcohol use
  • Sleep deprivation
  • Poor vision/hearing
  • Being in unfamiliar surroundings
  • Advanced age
  • Some medications
  • Low blood sugar
  • Infection or fever
  • Body fluid and electrolyte imbalance
  • Increased pain

What Are the Signs of Confusion?

As a family member or coach, you may notice the patient becomes inattentive, loses his or her perception of things and has a hard time with remembering. Some of the visual signs are:

  • Restlessness
  • Memory lapses as to their name, where they are and why they are there
  • Staying awake at night; sleeping during the day
  • Trying to get out of bed; wandering
  • Seeing things that are not there
  • Not acting like themselves; quiet, depressed, overly tired
  • Sometimes show aggressive behavior

How Long Will the Confusion Last?

The length of time that the confusion will last varies with each individual depending on the variables causing the confusion. Usually, confusion goes away within hours or days. Occasionally, it can last longer. Your doctor may order additional testing if the confusion does not resolve quickly. Listed below are some of the tests that may be ordered.

Blood tests to check for:

  • Electrolyte imbalance
  • Decreased blood count
  • Infection
  • Oxygen level
  • Decreased blood sugar level

Urine tests to check for:

  • Infection
  • Dehydration

Chest X-ray to check for:

  • Infection (pneumonia)
  • Possible reasons for decreased oxygen

EEG, CT scan or MRI to check for:

Changes within the brain

  • Infection (pneumonia)
  • Possible reasons for decreased oxygen

The Coach Can Help with Patient Confusion

  • Bring glasses, hearing aids and dentures to the hospital. Having necessities helps to keep things "normal". Notify the nurse whenever you bring in personal items.
  • Bring a few familiar itmes from home. A photo, favorite comforter or pillow, or the patient's own robe and slippers can help.
  • When talking to your family member, state one simple task or fact at a time.
  • Stay with your family member as much as possible. During this period of confusion, relatives should try to arrange shifts so someone can be with the patient around the clock.
  • If you detect new signs of confusion (memory or personality changes), you should report them to the nurse immediately.

An important thing to remember is that when patients have an episode of confusion, they do not have good control over what they say or do. It is also common for people to not recall being confused after the episode has gone away.

The best thing we can all do is to recognize the disorder, treat the cause promptly, and keep the patient safe until he or she recovers.

Caring For Your IncisionTake your temperature if you feel warm or sick. Call your surgeon if it exceeds 101.5 degrees F for more than 24 hours.

  • Keep your incision dry.
  • Keep your incision covered with a light, dry dressing until you do not have any drainage.
  • You may shower 24-48 hours after surgery, unless instructed otherwise. After showering, apply a dry dressing if incision is still draining.
  • Notify your surgeon if there is increased drainage, redness, pain, odor or heat around the incision.

Prevention of InfectionTake proper care of your incision as explained.

  • Notify your physician and dentist that you have had a hip fracture.
  • Take prophylactic antibiotics when having dental work or other potentially contaminating procedures. This needs to be done for at least two years after your surgery.

Infection

Signs of Infection

  • Fever greater than 101 degrees F
  • Change in color, amount, odor of drainage
  • Increased pain in hip
  • Increased swelling, redness at incision site

Blood Clots in Legs

Surgery may cause the blood to slow and coagulate in the veins of your legs, creating a blood clot. This is why you take blood thinners after surgery. If a clot occurs despite these measures, you may need to be admitted to the hospital to receive intravenous blood thinners. Prompt treatment usually prevents the more serious complication of pulmonary embolus.

Prevention of blood clots

 

  • Foot and ankle pumps
  • Walking
  • Compression stockings
  • Blood thinners such as Lovenox

 

Pulmonary Embolus

An unrecognized blood clot could break away from the vein and travel to the lungs.

This is an emergency and you should CALL 911 if suspected.

Signs of Pulmonary Embolus

  • Sudden chest pain
  • Difficult and/or rapid breathing
  • Shortness of breath
  • Sweating
  • Confusion

Prevention of Pulmonary Embolus

  • Prevent blood clot in legs.
  • Recognize a blood clot in leg and call physician promptly.

 

Hip Precautions

(If you need these special precautions, physical therapy will inform you.)

These precautions should be taken for the next three months, unless directed otherwise by your physician, to prevent dislocation.

AT ALL TIMES

  • DO NOT cross legs
  • DO NOT turn toes in or out
  • DO NOT bend at the hip past 90 degrees

Dislocation

Signs of dislocation

  • Rotation/shortening of leg
  • Unable to walk/move leg
  • Severe pain

Possible Long-Term Results to Expect After a Fracture

Fractures can take three to six months to heal, and it may take up to a year or more to fully recover from your injury. Many patients who fracture a bone will be able to return to pre-injury levels of function and independence with proper care and rehabilitation. However, some patients may not be able to return fully to pre-injury levels of function. This can be a significant life-changing event for some individuals.

 

  
Please feel free to contact us if you have any questions (423)431-6937

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