The applicability of the phase angle in assessing nutritional status among older women remains unexamined. This study aimed to evaluate the usefulness of the phase angle for nutritional assessment in older women with hip fractures and determine the cutoff value for malnutrition and the minimal detectable change (MDC). In this study, a combined cross-sectional and longitudinal design was employed. A total of 138 older female inpatients with hip fractures admitted to one of three rehabilitation units were included. At admission, nutritional status was assessed using the Geriatric Nutritional Risk Index, and the phase angle was calculated by bioelectrical impedance analysis. At one of the rehabilitation units, the phase angle was also measured 1 month after admission. Data from 90 participants (mean age: 83.11 ± 6.79 years) were analyzed. The cutoff phase angle for identifying malnutrition was 3.975° (sensitivity: 0.882 and specificity: 0.740). The MDC was 0.768°. The phase angle may be useful as a screening tool for nutritional assessment in older women with hip fractures.

Regional anesthesia is preferred over general anesthesia for benefits like hemodynamic stability, opioid-free pain relief, and reduced postoperative nausea. Its short duration may not fully address postoperative pain in orthopedic surgeries. To examine the evidence on dexamethasone as an adjunct to extend the duration of peripheral nerve blocks in orthopedic patients. A systematic review was conducted. The heterogeneity across studies precluded meta-analysis; the SWiM (Synthesis Without Meta-Analysis) method was used to analyze data. Seven studies included in this review demonstrate that IV dexamethasone prolongs peripheral nerve block duration and reduces opioid use, with improved pain relief within the first 24hours post-surgery. Implementing opioid-sparing strategies can improve pain management and reduce patients' exposure to opioid side effects. By extending the analgesic effects of peripheral nerve blocks, dexamethasone is a valuable addition to Enhanced Recovery After Surgery protocols, playing a key role in addressing the opioid epidemic.

Patients with intensive care unit-acquired weakness often fail to reach preadmission baseline values of functional ability at the time of hospital discharge. Progressive mobilization is the use of mobility early in the inpatient stay with intent to maintain muscle mass and strength. The nurse is uniquely positioned to encourage mobilization as a primary caregiver who can oversee patient mobility outside of scheduled rehabilitation sessions. The adverse effects of immobilization involve several complex mechanisms that contribute to protein imbalance, muscle deterioration, and progressive weakness that impacts body systems. Immobility may lead to functional decline and the development of intensive care unit-acquired weakness that impacts patients for years to months after discharge from the hospital. The multidisciplinary health care team may enable mobility by adopting mobility care bundles, using mobility score tools, embracing mobility assist devices, encouraging time spent outside of patient rooms, using descriptive mobility criteria to identify mobility strategies, and employing mobility coordinators.

Pediatric fractures that present without identified trauma can present a challenge to the nurse practitioner in the orthopedic clinic. Etiologies range from nonaccidental trauma to genetic and metabolic diagnoses that may have been previously undetected. It is imperative that the orthopedic nurse practitioner exercise critical thinking to recognize the potential for underlying diagnoses that can contribute to a child's injuries and make the appropriate referrals in a timely manner. This case study describes a child who presented to a pediatric orthopedic clinic with fractures in various stages of healing without known trauma, and through diligent investigation, was found to have previously undiagnosed chronic kidney disease.