Case Study

84-year-old female was admitted to Alexandria Rehabilitation and Healthcare Center from Inova Mount Vernon Hospital, where she initially presented after a fall. She recently underwent a right total hip arthroplasty and has been experiencing worsening right hip and lower back pain since her fall. Orthopedic consulted. No acute fracture seen on hip Xray. Patient maintained TTWB right lower extremity. Lumber spine Xray with scoliosis and extensive lumbar spondylosis. Past medical history significant for HTN, HLD, COPD, hypothyroidism, OSA, and bipolar disorder. Patient was admitted to Alexandria Rehab for medical optimization and ongoing therapy services.

Nursing Interventions:

Medication Management – Amlodipine, Depakote, Synthroid, Bupropion, Gabapentin, Oxycodone PRN, Lovenox
Close Monitoring of Labs including CBC and BMP

Therapy Interventions:

Followed by our PMR Provider, Rubeena Vincent, CRNP.
Goals: Patient’s goal was “to return to her prior level of function”.

Initial Evaluation:

Patient is TTWB on right lower extremity. Upon admission, she was independent for bed mobility and required contact guard assistance for transfer. She also required assistance for self-care including supervision for upper body dressing, Min A for
toileting, and Mod A for lower body dressing.


Individualized therapy plan was developed consisting of physical and occupational therapy.

Discharge Evaluation:

She made significant gains with therapy to regain her independence. At discharge, she advanced to supervision to ambulate 200 feet with RW and safely ascend/descend 12 steps. She also regained her independence with self-care including Mod I for bathing, toileting, and dressing.

After a successful stay at Alexandria Rehab, the patient was discharged home with support from Esprit Home Health. She will continue to be supported by her PCP, Dr. Adeline Viyuoh in the community.

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