#7001
Jen
Member

I had a gentleman move into LTC from retirement who had recently been discharged from hospital post hip replacement surgery (if I remember correctly he was about day 7 post-op). He had moved in the evening prior and had remained in bed that entire evening/night. He was not responding verbally to our team or eating but was opening his eyes and appeared to be understanding when we were speaking to him. His wife had told us this was not his baseline and she was quite concerned. She stated when he first was discharged home to the RH he had been physically aggressive and they started a medication for this. In reviewing his medications the home had started him on a fairly high dose of risperidone. This gentleman was not receiving any pain medications and being post-op I wondering if the ‘aggression’ the home was witnessing was due to pain and if his current status was due to the risperidone. I also noted an infection along his incision line. With approval from his wife I discussed this with our doctor which he was now under the care of. She was in agreeance – we reduced and discontinued the risperidone and initiated some proper pain control as well as antibiotics. After about 2 weeks this resident was ambulating with a walker, eating well, and verbally chatting with team and other residents. I feel this was critical thinking as I obtained a variety of data, used my pre-existing nursing knowledge, and thought outside the box for a solution. I also evaluated the outcome of this decision path.