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Admission to hospital
- Admitted due to 3 weeks of increased shortness of breath and cough.
- DX = acute COPD exacerbation and failure to cope.
- Treated with antibiotics and steroids.
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Geriatrics and Palliative Care Consult
- Geriatrics identified mild-moderate Dementia/Alzheimer’s disease.
- Geriatrics suggested palliative care consult.
- Palliative care determined the patient was not appropriate for Hospice at this time.
- Comfort
- Quality over quantity of life. -
Transfer to Complex Care
Patient transferred to complex care while awaiting placement in LTC. -
Fall Incident
- 01:35 → Bed alarm sounded; patient found on the floor, confused, and searching for his friend “Archie.” Complained of left elbow pain.
- 05:45 → Patient reported pain in buttocks; bruise noted on the right hip. Pain medication administered.
- 08:00 → Doctor notified of the fall.
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Post Fall Assessment
- Imaging → Bilateral hip and pelvic x-rays ordered, showing suspicion of pubic fracture. CT scan later confirmed comminuted fractures of the right and left pubic inferior ramus.
- Orthopedics Consult → Assessed the patient with the POA (niece) present. Decided the patient was not a surgical candidate and ordered weight-bearing as tolerated.
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Post Fall Evolution
- Patient’s mobility significantly declined; staff used a Sam Hall Turner with difficulty.
- Patient primarily stayed in bed and consumed minimal fluids.
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Palliative Care Initiation
- Patient’s condition continued to decline.
- Nurse Practitioner discussed palliative care with the POA; palliative care order set initiated.
- Family declined Hospice transfer.
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Patient Passed Away
Patient passed away in the hospital. -
Credits
All images were AI generated by @DelgadoHD using Dall-E, Designer Bonkers prompts.