Complete Assessment Simulator

**Patient Background:**
Margaret Thompson is a 72-year-old female admitted to IRF following left hip fracture repair (ORIF)
performed 5 days ago at acute care hospital. She fell at home while walking to bathroom at night.

**Past Medical History:**
- Type 2 Diabetes Mellitus with peripheral neuropathy (on metformin 1000mg BID, gabapentin 300mg TID)
- Hypertension (on lisinopril 20mg daily)
- Morbid obesity (BMI 42, weight 245 lbs, height 5'4")
- COPD (on albuterol inhaler PRN, increased use during acute stay)
- Chronic kidney disease Stage 3 (baseline creatinine 1.8 mg/dL)

**Acute Hospital Course:**
- Admission glucose 340 mg/dL, required insulin sliding scale
- Developed acute COPD exacerbation requiring increased nebulizer treatments and 2L O2
- Albumin 2.6 g/dL on admission
- Received 2 units PRBCs for Hgb 7.2 g/dL post-op
- PT/OT initiated, patient requires mod assist for transfers, min assist for ADLs

**Preadmission Living Situation:**
- Lived alone in single-story home
- Independent with all ADLs and IADLs
- Daughter lives 30 minutes away, visits weekly

**Current Functional Status (Admission to IRF):**
- Alert and oriented x3, follows commands
- Eating: Feeds self independently but slowly (6)
- Grooming: Requires setup of items, completes independently (5)
- Bathing: Requires minimal physical assistance (3)
- Dressing Upper: Requires setup, completes independently (5)
- Dressing Lower: Requires moderate physical assistance (2)
- Toileting: Requires minimal physical assistance (3)
- Bladder: Continent, no accidents (7)
- Bowel: Continent, no accidents (7)
- Transfers Bed/Chair: Requires moderate physical assistance (2)
- Transfers Toilet: Requires moderate physical assistance (2)
- Transfers Shower: Requires maximal physical assistance (1)
- Locomotion: Wheelchair level, requires minimal assistance to propel 50 feet (3)
- Stairs: Not assessed, patient non-weight bearing (1)
- Comprehension: Understands complex conversations (7)
- Expression: Expresses complex ideas clearly (7)
- Social Interaction: Appropriate social interaction (7)
- Problem Solving: Recognizes problems, makes appropriate decisions (6)
- Memory: Recalls daily routines, recognizes people (6)