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Betty, an 82-year-old widow, arrives to an acute care facility by ambulance. Because Betty had not answered her phone since noon yesterday, her daughter went to her home to check on her. She found Betty lying on the kitchen floor, incontinent of urine and stool, with complaints of (C/O) pain in her right hip. Her daughter reports a past medical history (PMH) of hypertension (HTN), angina, and osteoporosis. Betty takes propranolol (Inderal), nitroglycerin patch, indapamide (Lozol), and conjugated estrogen (Premarin) daily. The daughter reports that her mother is normally very alert and lives independently. On examination you see an elderly woman, approximately 100 pounds, holding her right thigh. You note shortening of the right leg with external rotation and a large amount of swelling at the proximal thigh and right hip. Betty is oriented to person only and is confused about place and time. Betty’s vital signs (VS) are 90/65, 120, 24, 97.5°F; her Sao2 is 89%. She is profoundly dehydrated. Preliminary diagnosis is fracture of the right hip.

-Need to come up with 2 nursing diagnoses & prioritize diagnoses & list them in order of priority
- Develop a care plan
-provide the evidence subjective and objective data as to why chose the diagnoses
-indicate which diagnosis is the priority
-develop a client centered plan with measurable goals
-list references in APA format 6th edition
I’m not looking for anyone to “Do” my homework just some help on if I’m going the right direction etc. I’ve already done the diagnoses and want to make sure what I was thinking was correct! For the diagnoses I thought the most important was Fluid volume deficit, related to inadequate fluid intake. And secondly then acute pain, related to the fractured right hip.

Since she is profoundly dehydrated I know that with older people it affects them more serious and a higher chance of near fatal situation. So I thought this would be the most important to address first and then the patient is obviously in a lot of pain. So I thought the pain would be next and that these two would be the most important diagnoses for this scenario?