Mr. Jones is an 80-year-old man who lives in his apartment in a large city. His wife passed away five years ago from cancer, and his adult children live in other states; the closest is a son who lives six hours away by car. Mr. Jones has kept himself quite active since his wife passed away. He goes to the senior center three or four times a week, meets up with some male friends for coffee almost every morning, and on Friday nights, goes to the bingo hall to play some games. He does have someone come in to help with housework and laundry.

Last week, Mr. Jones was leaving his apartment building when a neighbor’s small dog got loose, with the leash trailing behind it. The dog went to jump up on Mr. Jones, and in the process, Mr. Jones became tangled in the leash and fell hard on his right side. He was in significant pain, and his right leg was at an odd angle. An ambulance was called to take him to the hospital. X-rays were ordered for his leg and hip, revealing a fracture in the tibia at the head with some bone displacement and a fracture in the femoral head. Mr. Jones underwent surgery to place a plate and screws to correct the tibia fracture and additional surgery to address the fracture in the femoral head.

You are the nurse assigned to Mr. Jones upon his admission to the unit after surgery. He is complaining of pain rated at 9/10 and does not want to move. He is restricted in the range of motion for the femur repair and has a splint on his leg for the tibia fracture.

1. What are your concerns as a nurse about the mobility of this client?
2. What assistance will he require from the nursing team to provide ADLs (Activities of Daily Living) and personal hygiene?
3. What are your recommendations for assistive mobility devices for this client?
4. What vital sign changes could you anticipate due to his mobility restrictions?