Community Nurse Team Leader
Broomfield Community Hospital
06 August 2021
Dear Mrs Adison,
Re: Mrs Margarat Adam, 08 May 1945
Mrs Margarat Adam, who has been recuperating from left total hip replacement, requires home visit from your service following her discharge tomorrow.
On 21 July 2021, she presented with fractured hip following a fall while walking at home. Fracture of left hip acetabulum was revealed by an x-ray; therefore, the surgery was performed. Postoperatively, delirium for 5 days was noted. In addition to regular medication, injection paracetamol 1 gram thrice daily, deltaparine 5000 IU and dulcolax 10ml were prescribed. Mobilization twice daily was initiated under supervision of the physiotherapist.
On 3 August 2021, wound was re-dressed. He could walk up and down of the bed with the support of frame. Deltaparine was self-administered under supervision. On today's assessment, an excellent recovery has been observed. He is able to walk few steps including stairs with the help of a stick. Showering, dressing and washing clothes were managed without assistance. However, slight swelling on hip region was identified. Route of paracetamol was replaced from intravenous to oral.
Message Adam, a retired teacher is a widow and has no close relatives; however, her neighbour is very supportive. Meals on wheels has been preferred. Macular degeneration followed by blurred vision and fracture of the wrist were diagnosed in 2018. Fractured ankle and osteoporosis were ruled out in 2012 and 2020 respectively.
Based on the aforementioned circumstances, home visits twice weekly to monitor medication compliance, pressure ulcer and swelling over wound would be profoundly beneficial. Encouragement for continuing exercise program would be required. Wound dressing and antiembolism stockings should be provided on 6 September 2021. Deltaparine needs to be ceased on 17 August 2021. Appointment for medicine review has been scheduled on 22 September 2021.
In case additional information is required, please do not hesitate to contact me.
Registered Nurse Orthopedic ward