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Patient Discharge Guide for Hip Fracture Patients

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Patient Discharge Guide for Hip Fracture Patients Patient Discharge Guide for Hip Fracture Patients Ortho Spine Unit 405-515-3700 Physical Therapy 405-515-1712 Orthopedic Nurse Navigator 405-664-6696 3300 HealthPlex Parkway Norman, OK 73072 NormanRegional.com Contents 6 Vital Factors .........................................3 Safety ........................................Section D Sleeping Positions ................................... 26 Caring for Yourself at Home ..........Section A Home Safety .......................................... 27 Managing your Pain ...................................6 Bathroom Safety ..................................... 28 Anti-coagulants ........................................6 Bathing ................................................. 29 Constipation .............................................6 Kitchen Tips and Safety ............................30 Positioning your Leg .................................7 Car Transfers ...........................................31 Homemade Ice Pack ..................................8 Curb/Stair Training .................................. 32 Hip Precautions ........................................9 Preventing Dislocations .............................12 Energy Conservation ...................Section E Weight Bearing Status ...............................13 Incision Care/Dressings .............................14 Energy Conservation ................................36 Body Changes .........................................14 Coping with Stress ...................................14 Activity Guidelines ......................Section F Intimacy .................................................14 Activity Guidlines ....................................38 Preventing Potential Follow Up Care ............................Section G Complications .....................................Section B Follow Up Care .......................................40 Medication Precautions .............................16 Infection .................................................17 Blood Clots .............................................17 Exercise Guide ............................Section C Exercise Guide ........................................20 1 2 6 Vital Factors for a Successful Recovery 1. ELEVATION is for swelling. It is normal to have increased swelling in your legs once you are home. You need to elevate your leg above the level of your heart for at least 30 minutes two times a day. 2. ICE is for pain. It is normal to have some increase in pain after you are at home. You need to ice your knee for 20 minutes while you are elevating your leg, at least two times a day. Remember to protect your skin by placing a layer of cloth between the ice and your skin (such as a towel or pillow case). 3. BLOOD CLOT PREVENTION. Your surgeon has prescribed a blood thinner for you. This medication must be taken as prescribed at the same time every day. 4. CONSTIPATION. Constipation is normal after surgery. If you have not had a bowel movement in 2 days, you need to take Miralax twice a day until you have a bowel movement. 5. ACTIVITY AS TOLERATED. It is very important to move and stay active once you Please tear this page out this page and keep tear handy somewhere Please are at home. You need to be up and moving as tolerated. If you feel you have over exerted yourself, your first step needs to be to rest, ice and elevate your leg. 6. NUTRITION. Calorie and protein needs are higher after your surgical procedure. Proper nutrition is important for optimal healing and recovery. Aim to eat 3 well balance meals a day with 2 snacks as tolerated. *If you have any questions or concerns regarding these 6 factors, call Melanie Garner at #405-664-6696* Please tear this page out and keep somewhere handy 3 4 Caring for Yourself at Home Section A 5 . 3 If you miss a dose of this medication, take it as soon as you remember—unless it’s Caring for almost time for your next dose. In that case, just wait and take your next dose at the Yourself at Home normal time. Do not take a double dose. 4 Use an electric razor to shave. MANAGING YOUR PAIN . 5 Anticoagulant medication can make bleeding harder to stop. It is normal to have moderate pain after a major surgery such as this. Pain medication will be CONSTIPATION prescribed for you; with pain under control, you’ll be able to get back to an active life sooner. Take Constipation is one of the most common issues pain medication, with food, only as directed, taking patients face after surgery. Surgical anesthesia, each dose before pain becomes severe. Plan lack of appetite, limited physical activity and opioid ahead by taking pain medication an hour prior to pain medications can all cause constipation. While physical therapy or strenuous activities such as you were staying in the hospital you were given bathing. Icing and elevating your leg is extremely stool softeners: Colace (docusate sodium) and important to managing your pain, make sure you Miralax (polyethylene glycol). Continue these at are following your icing and elevating protocol. home unless you are having diarrhea. Eating fiber If you develop sudden pain—rest with ice and rich foods and drinking plenty of water will also elevation should be your FIRST step to manage help. High fiber containing food groups include this. whole grains, beans, fruits, and vegetables. IF you have not had a bowel movement in two days, take Miralax twice a day. If you still don’t have a bowel ANTI-COAGULANTS movement within another two days, and you have Your surgeon will prescribe medication that helps no history of kidney/renal problems then drink ½ prevent blood clots from forming in your blood. bottle of magnesium citrate. If no bowel movement This may be aspirin or another medication in pill after 4 hours drink the remaining 1/2. Do not or shot form. It is very important that you take this let constipation go on too long. IF still no bowel medication for as long as directed by your surgeon. movement after these interventions, contact your Your nurse will review any specific instructions primary care physician or ortho surgeon. for the medication you surgeon has prescribed for you. Do not strain to have a bowel movement. Guidelines for use: When straining or bearing down to have a bowel 1. Don’t take any new medications, including movement it is common to hold your breath, this over-the-counter medications, like naproxen combination can trigger a vasovagal response. or ibuprofen, without checking with your Symptoms include dizziness, tunnel or blurred surgeon first, because they may affect your vison, sweating, fainting and can trigger a sudden blood thinner. increase in blood pressure and/or an abnormal . 2 Take your anti-coagulation medication at the heart rhythm. If you are unable to pass stool same time every day. without straining increase the stool softeners to twice daily. 6 POSITIONING YOUR LEG 1. Change your position at least every 45 minutes during the day to avoid stiffness. 2 Do not sit with feet on the floor for more than 30 minutes at a time. 3 Change positions frequently, do not sit still too long. It is better to get up more often for short periods then to wait and get up less, but for longer periods. 4 When you are elevating your leg, do your ankle pumps. They will reduce swelling and improve circulation. 7 Homemade Ice Pack 1. Fill the plastic freezer bag with 1 cup of rubbing alcohol and 2 cups of water. 2. Try to getIce as For much 20 Minutesair out of at the LEAST freezer bag before sealing it Twiceshut. A Day 3. Place the bag and its contents inside a second freezer bag to contain any leakage (zipper size in first). 4. Leave the bagHomemade in the freezer Ice Pack for at least an 1. Fill the plastic freezer bag with 1 cup of rubbing alcohol and 2 cups of water. hour.2. Try to get as much air out of the freezer bag before sealing it shut. 3. Place bag and its contents inside a second freezer bag to contain any leakage (zipper side in first). 4. Leave the bag in the freezer for at least an hour. Remember to ice and elevate your leg after activity and physical therapy. Remember to ice and elevate your leg after activity and physical therapy. 8 9 ICE for 20 minutes at LEAST twice a day. Hip Fracture: Hip Fracture: Hip HipPrecautions Precautions after surgery After Surgery If your hip fracture was repaired with a Partial (Hemi or Bipolar Arthroplasty), a Total Hip ReplacementIf oryour you hip fracturehave been was repaired instructed with ato Partial follow (Hemi Hip or BipolarPrecautions Arthroplasty), on your a Total discharge Hip Replacement or you have been instructed to follow Hip Precautions on your discharge paperwork. paperwork. Total Hip Replacement The Following Sections apply to you: The Following 1. PSectionsreventing Dislocations apply to you: 2. Total Hip Precautions 1. PreventingIf your fracture Dislocations was repaired with plates and screws or a rod, and your discharge instructions to do not include hip precautions please disregard the sections listed above. 2. Total Hip Precautions If your fracture was repaired with plates and screws or a rod, and your discharge9 instructions to do not include hip precautions please disregard the sections listed above. 10 please talk to your occupational or physical therapist so they can provide and review the Totalproper Hip positions you can use to maintain your hip precautions during sexual activity. Replacement PrecautionsTotal Hip Replacement Precautions To practiceTo safe practice movement safe until movement your hip replacement until your has hip replacement has fully healed, you will need to take fully
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