NUR341: Detailed Assessment of Fall and Pressure Injury Risks for Flo

This report presents a comprehensive risk assessment for a 70-year-old female patient, Flo, focusing on fall risk, functional limitations, and pressure injury risks. The assessment utilizes a fall risk assessment tool, evaluating factors such as recent falls, medication use, physical and psychological status, and cognitive function, revealing a high-risk score. The functional assessment explores the patient's ability to perform daily activities, highlighting difficulties with tasks like running, driving, and rolling over in bed, due to hip pain and cataracts. Furthermore, the report addresses pressure risk injuries, including bursitis and tendinitis, recommending preventive measures such as avoiding repetitive activities and sleeping positions that exacerbate pain. The report concludes with medication recommendations, including Ibuprofen for pain relief, Gliclazide for asthma and type 2 diabetes, and Irbesartan for hypertension, tailored to address the patient's specific health concerns and improve her quality of life. The report emphasizes the importance of regular check-ups, a balanced diet, and lifestyle adjustments to manage the patient's conditions effectively.

NUR341 Assignment 2

TABLE OF CONTENT
INTRODUCTION...........................................................................................................................4
Question -1.......................................................................................................................................4
Fall assessment ............................................................................................................................4
Presenting the functional assessment...........................................................................................5
Pressure risk injury assessment....................................................................................................7
Question 2 .......................................................................................................................................8
Choosing the medication factor to provide to the patient............................................................8
CONCLUSION ...............................................................................................................................9
REFERENCES .............................................................................................................................10

INTRODUCTION
This research is about the 70-year-old female lady Flo that is suffering from the hip pain
and other disease and will provide the detailed information about the fall assessment and
Pressure risk injury assessment for better understanding.
Question -1
Fall assessment
The fall assessment is mainly used for analysing the risk level in the individual. It helps
in showing high, moderate and the low risk in any individual along with that help in analysing
the overall risk factor for any person during certain point of time (Sattar and et.al., 2021). Also,
low risk helps in analysing and reducing the falling chances whereas high risk results in higher
chances for falling and being more injured.
Thus, the main goal of the fall assessment is to assess the risk involved for Flo that is
facing various injuries and the pain in right hip.
Fall risk status
Risk factor level Risk scoring out of 10
Recent falls  None in last 12 months
 one or More between 3
to 12 months
8
6
Medications
(acetaminophen, ibuprofen,
aspirin, GTN)
 Not taking any of these
 Taking one
 Taking all
 Taking two
2
1
0
2
Physical status (MSK)
(swelling, intact of skin,
decreases the movement due to
pain, not able to derive and
walk properly, very tender on
palpation, blue and red colour
to right hip that extend to right
 Does not appear to
have any of these
 Mildly affected
 Moderately affected
 Severely affected by
one or more
0
4
5
8

buttock)
Psychological status (weak
eye sight, low level of
consciousness, stress,
depression)
 Does not appear to
have any of these
 Midley affected
 Moderately affected
 Severely affected
3
3
5
7
Unsteadiness when standing,
walking and driving
 Completely dependent
 Moderately steadiness
 Minimal steadiness
 Severely steadiness
2
2
3
6
Cognitive status
 intact
 Mildly impaired
 moderately impaired
 severely impaired
0
0
0
0
Total 8/20
Low risk from 1-5, medium risk from 5-7, high risk from 8 to 10.
From the above table it is summarized to Flo that risk scoring is at high level, which is
further analysed through the fall assessment that scored at 8 out of 10. That further indicates that
Flo is at high risk level due to the injury pain at the right hip. Also, this assessment indicates that
due to old age of Flo which is 70 she is suffering from low stamina that is impacting the health in
negative manner. Further, it is analysed that risk in falling would be high due to the disease and
the hip pain. Thus, This assessment would help in giving the recommendations in taking the
proper medications which help the flo to remain safe and aware during any kind of pain. Thus,
this assessment is being done by using the questionnaire tool and also through conducting all the
secondary research of flo.
Presenting the functional assessment
It is type of assessment that is continuous and collaborative process that relates to
combining, asking and observing individual behaviour and the skills that are naturally occurring
in the everyday life and are faced across the multiple situations at certain times.

Activities Extreme
difficulty
Quite bit
difficulty
Moderate
difficulty
A little of
difficulty
No
difficulty
Patient
score
Any of the
usual
household
work
0 1 2 3 4 3
Driving a
car
0 1 2 3 4 1
Performing
heavy
activities
around the
home
0 1 2 3 4 0
Running on
even ground
0 1 2 3 4 0
Rolling over
the bed.
0 1 2 3 4 2
Putting
shoes or
socks
0 1 2 3 4 2
Total
column
score
- 8
Thus, from the above the functional assessment it is suggested to patient that having the
age of the 70 year some symptoms would tend to increase over the age but in-spite of it she is
unable to perform the activities and needed to take extra precautions while carrying out certain
tasks at the home. (Griffiths and et.al., 2018.). Moreover, activities like running on the ground
could not be performed due to pain in the right hip that also creates problems in the movement

and cause extreme pressure in moving certain things from one place to another. Furthermore,
having the problem of the cataracts the patient is unable to drive the car and hence such
functional problems have does not need to be overlooked for longer period. Moreover, from the
above table it can be summarized that activities like rolling on the bed would be unable to be
performed by the patient due to number of falls in past years that would only make the situation
worse and problematic and hence this need to be taken special care of in the future.
Also, this functional assessment that was done through asking the certain points to the
patient and thus it can be concluded that patient need to take proper care and rest so that more
advantages could be gained out in the specific time-frame. Also, through functional assessment it
could be said that regular check up is required so that functional disability of the patient might be
improved over the period (Asmirajanti and et.al., 2019). Moreover, due to the age factor the
patient is not able to conduct the daily routine activities in well-defined manner. Furthermore,
through this assessment it can be said that it is very risky at this stage for the patient to carry out
the rigours activities while working or sitting at home. Also, the immediate treatment of such
problems could be relived through taking the daily medicines and rest as at this age some
treatments would not make things absolutely right and best. Also, functional assessment suggests
that patient should involve in those activities that are essential for living or enjoying the life and
hence the not required activities could be avoided to some extent.
Pressure risk injury assessment
From the above section it has been suggested to Flo that if more pressure is exerted on
the hip area while carrying out any activities than there are more possibilities that it might lead to
bone fractures as due to age factor the bones become weak and hence they are more likely to
break during any kind of fall or when any kind of pressure is been put into that area.
Furthermore, another risk that is identified for Flo due to extreme pressure is Bursitis which is
type of problem that is faced when sacs of liquid is filled in the bones, tendons and muscles
(Hawthorne and Gordon, 2020). Moreover, when bursae get inflamed than they cause high pain.
Thus, in the old age of Flo such type of pains would be unbearable making the situation worse.
Furthermore, this situation occurs when certain activities is done in the repetitive manner and
therefore Flo should avoid doing activities that causes any kind of pain in the hip or other body
parts. Also, such activities tend to create swelling in affected areas and in worst they might
permanently prevent the hip to function normally for the lifetime. Pressure risk would also take

form of cancers such as tumours where the chances of recovery are very minimum for Flo if
certain precautionary steps are not followed properly. Thus, it is suggested that patient should
take sessions where the physical movement are done in form of therapy. Furthermore, it is
advised to Flo that to avoid smoking and other drug intake activity she needs to take active part
in the medication camps where with help of trainer she would be able to meditate in form of
yoga and would be able to ensure the balanced diet for the future.
Moreover, she should go for walk and avoid watching film and other shows at the home
to maintain the best eyesights and vision for conduct of any routine activities in the future . Also,
it can be said from the report another risks that is likely to happen if pressure is been given is
Tendinitis that is defined as some thick band of tissue that are attached to the muscles that cause
more irritation of the tendons (Zeleníková and et.al., 2020). Moreover, to avoid such situation it
can be said that Flo need and try to sleep on the right side of the body so that not much pain is
exerted on left while sleeping or just laying down on the bed or any other place. Furthermore,
support of pillow or any soft material might also be used so that not more pains is felt on the
affected area. Moreover, for issue of low eyesights if more pressure is exerted on retina than it
might result in complete lost in the vision. Hence, through this assessment the patient is
suggested to take more rest and eat lot of vegetables and fruits in her diet. Thus, it would be
helpful in maintaining the strong eyesights and are also effective in reducing the overall number
of dosage of medicines that are been taken on daily basis by patient.
Question 2
Choosing the medication factor to provide to the patient
From the above all analysis that has been undertaken it can be said that Flo is been
recommended certain things that will help to solve the problems to some extent.
 Firstly, it is been recommended to Flo for hip injury and pain problem that Ibuprofen
medicine needs to be taken when pain is out of control as this medicine will help to relive
hip pain that is been happening due to the movement or rolling from the bed (Hessels and
et.al., 2019). Also, this medicine had been recommended as this medicine would help in
reducing the fever and would allow in relieving the minor aches that is been caused due
to falling. Furthermore, this medicine is very effective in reducing the overall swelling,
any kind of pain or fever. However, it is suggested to patient that this medicine needs to
be consumed in right proportion otherwise it might cause certain side effects such as it as

problems of indigestion and feeling of dizziness (Gaalan and et.al., 2019). Also, it might
also cause the problem of headaches and if any of such problems occurs before of after
the consumption than patient had to ensure to drink plenty of fluids so that same might
be vaoided..
 Another suggestion which is provided through abnormal findings is that the patient is
having the asthma and type 2 diabetes which can be cured through taking the
sulfonylurea from the gliclazide medicine that is anti allergic drug that is used to treat
the asthmatic patients in the best manner. Also, through findings it was identified that Flo
is not able to walk properly on the ground due to the hip and breathing problem and
hence this tablet would help in providing the instant relief that is very much required for
the patient on daily basis. Moreover, through using this tablet it would help in increasing
the amount of insulin in the pancreas that further help in lowering the sugar levels. Also,
this medicine comes as the standard and slow release tablets that is good for any diabetic
patients that are suffering a lot (Su and et.al., 2020). However, this medicine to have the
side effects such as sometimes it makes the sugar level so much lower that it might
negatively impact the concentration level of the patients. Thus, while taking this medicine
it is suggested to Flo that she should take very healthy and balanced diet so that medicine
actually works inside the body and shows best results.
 Moreover, it is suggested to the Flo that she should intake Irbesartan medicine as it
would help in treating the problem of the hypertension and further it is advised to take
one each day so that blood pressure levels are also controlled and patient is relived from
stress (Ossetrova and et.al., 2018). Although, it is suggested to Flo that this medicine
need not be continued for not more than one month and prolonged period as it has various
side effects such as it might cause faintness and muscle weakness.
Thus, through the overall assessment it can be said that patient is at high risk of having
high blood pressure and hypertension if proper medication such as yoga, light exercises and
much more are not followed in right manner. Also, such exercise will help in providing more
body relaxation. Moreover, through following above steps Flo would be able to take preventive
measures so that impact of the risk might be minimized to some extent.

CONCLUSION
From this report it is being analysed that the condition of flo facing due to various injures
and the pain caused in the right hip. With assessing the risk, it is being analysed that there is the
high risk of the flo for falling due to the pain and diseases caused. Also, functional assessment
helps in analysing about the functional status of the flo. Lastly, pressure injury risk assessment in
report will helps in determining the factors that increased pressure and causes diseases to the flo.

REFERENCES
Books and Journals
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practice. Journal of Holistic Nursing, 38(1), pp.147-155.
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Zeleníková, R. and et.al., 2020. Unfinished nursing care in four central European
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