follow the instruction Requirements:

nursing multi-part question and need an explanation and answer to help me learn. follow the instruction Requirements: 2 or 3 pg Name: Course: Teach. Marcano Dexterity Module I. Customer history Documentation and care plans (NANDA, NOC, NIC) Patient Education Carefully give you the following case study and answer the 3 critical thinking questions in the Nursing Process. Provides a plan of care for nursing diagnosis: Ineffective maintenance of health related to an intake higher than your metabolic needs. It performs in PES format the three nursing diagnoses established in the case study according to theinterfered need. A patient undergoing surgery Mart aRamírez is a 74-year-old widow of Peruvian origin, widow, who lives alone in a complex for the elderly. She is active there as well as in the Lutheran Church. He has been in good health and has been independent, but has progressively lost activity due to arthritic pain and stiffness. Ms. Ramirez has degenerative joint changes that mostly affect the right hip. On the recommendation of her doctor and after discussing it with her friends, Ms. Ramírez has been admitted to the hospital for a total right hip replacement. The intervention has been scheduled for 8:00 in the morning the next day. Ms. Eva Colón, a close friend and neighbor, accompanies Ms. Ramírez to the hospital. Ms. Ramirez explains that her friend will help her at home and in the care of the wound and the exercises that are indicated. Vital signs before intervention P/72. R/18, T/37.5, BP/112/70. ASSESSMENT Gloria Camacho, RN, is assigned to Ms. Ramirez's care when she returns to her room. Ms. Camacho makes a complete assessment from head to toe and determines that Ms. Ramirez is sleepy but oriented in all three areas. The skin is pale and slightly cold. Ms. Ramirez says she is cold and asks for more blankets. Ms. Camacho places a cotton blanket near Ms. Ramirez's body, adds another blanket to the bed, and sets the bedroom thermostat to a higher temperature. Ms. Ramirez says she feels no pain and would like to sleep. You have normal,exertionless breathing and vital signs comparable to preoperative readings. Ms. Ramirez is in NPO. You are being infused with an intravenous solution of glucose and water at 100 mL/h through an infusion pump. No redness or edema is observed at the infusion site. Ms. Camacho notes that the antibiotic ciprofloxacin hydrochloride will be given orally when the patient is able to tolerate fluids. Ms. Ramirez has a large bandage over the right side and upper thigh and hip with no indication of wound drainage. A tube protrudes from the distal end of the bandage and is attached to a passive suction device (Hemovac). Ms. Camacho empties 50 mL of dark red drainage from the suction device and records its quantity and characteristics in the register. Ms. Ramirez has a Foley catheter placed with 250 mL of clear amber urine in the declining bag. When Ms. Ramirez's lower extremities are assessed, Ms. Camacho notices slightly cold and pale feet with a quick capillary filling time on both sides. The dorsal and posterior tibial pedium pulses are strong and equal on both sides. Ms. Camacho notes a slight pitting edema in the right foot and ankle compared to the left limb. You also see sensation and ability to move both feet and fingers, without numbness or tingling (paresthesias). Ms. Camacho records the above observations on a record sheet. After making sure Ms. Ramirez is in a safe position and can reach the call light, Ms. Camacho gives Ms. Ramirez's friend, Ms. Colon, a progress report. DIAGNOSTICS Ms. Camacho makes the following postoperative nursing diagnoses to Ms. Ramírez. Risk of right hip infection related to loss of normal skin integrity from surgical incision. Risk of injury related to possible dislocation of the right hip prosthesis secondary to total hip arthroplasty. Pain related to incision in the right hip and the position of arthritic joints during surgery. EXPECTED RESULTS The expected outcomes set forth in the care plan specify that Ms. Ramirez: You will regain the integrity of the skin at the right hip incision without experiencing signs or symptoms of infection. He will demonstrate (together with Mrs. Colón) an adequate aseptic technique while changing bandages. Verbally express the signs and symptoms of infection that you should report to your doctor. Describe the measures to be taken to avoid dislocation of the right hip prosthesis. Communicate pain control in the incision and arthritic joints. It will remain fever-free. PLANNING AND IMPLEMENTATION Ms. Camacho develops an assistance plan that includes the following interventions to assist Ms. Ramirez during her postoperative recovery. Use the aseptic technique while changing the bandage. Monitor temperature and pulse every 4 hours to assess elevation. Assess the wound every 8 hours for purulent drainage and odor. Assess the edges of the wound to see its approach, edema, redness or swelling above the expected inflammatory response. Teach Ms. Ramirez and Mrs. Colon how to use the aseptic technique while assessing the wound and changing the bandage. Teach Ms. Ramirez and Ms. Colon the signs and symptoms of infection and when to communicate observations to the doctor. Review and discuss with Ms. Ramirez the written materials on total hip replacement. Convey an empathic understanding of Ms. Ramirez's incision and joint pain. Medicate Ms. Ramirez every 4 hours (or when ordered) to maintain the therapeutic blood concentration of the analgesic. EVALUATION Throughout Ms. Ramirez's hospitalization, Ms. Camacho works with her and Ms. Colon to make sure Ms. Ramirez can care for herself upon discharge from the hospital. Five days after surgery, Ms. Ramírez is discharged with a very approximate incision and no signs of infection. Before discharge, Ms. Camacho with the help of Ms. Colón and asks Ms. Ramírez to usethe incision and she performs it appropriately . With minimal assistance, Ms. Ramirez is able to replace the bandage using an aseptic technique. You can cite the signs and symptoms of an infection, take your oral temperature, and describe preventive measures to reduce the chances of your hip replacement disluxing. Due to her reduced mobility for the past 5 days, Ms. Ramirez says she notices that the osteoarthritis of her "old bones" is "growing." He reports less pain in the right hip than before the intervention. Ms. Ramirez tells Ms. Camacho that she will be back next summer for surgery on her left hip. CRITICAL THINKING IN THE NURSING PROCESS 1. Describe Ms. Ramirez's safety risk factors; what changes in her home environment should she advise to promote safety until she recovers more fully? 2. Why does Ms. Ramirez receive ciprofloxacin even if she does not have any signs of infection? What education would you give him? 3. Ms. Ramirez's clotting time is slightly elevated due to an anticoagulant that was ordered. Why would this type of medication be ordered? Consider the age of the patient and the area of surgery. 4. Ms. Ramirez weighs 15 kg more than her ideal weight and has osteoarthritis. Develop a care plan for nursing diagnosis Ineffective health maintenance related to an intake higher than their metabolic needs. Individual Care Plan Name of the student:____________________ N# of the student_______________ Date________ Patient information Name of the Patient:_______________ sex __F __M age____ Religion__________ Estado Civil___________ Doctor Diagnostic: _____________ HEALTH HISTORY BASED ON FUNCTIONAL PATTERNS Name__________________ Date_________________ Medication used in the Home:_________________________ Medicines Used During Hospitalization