Total knee replacement is also referred as total knee arthroplasty (TKA). This is a surgery used in the treatment of severe osteoarthritis. The surgery involves the replacement of the damaged part of the knee joint with an artificial joint (also called prosthesis). The initial treatment of osteoarthritis involves weight loss, knee braces, physical therapy and medications. However surgery is recommended when the symptoms of osteoarthritis such as pain and stiffness is not controlled with medications.
During the surgery for a total knee replacement, the patient is put under general anesthesia. Then an incision is made in the front of the knee. Through this incision access is gained into the joint capsule. The damaged portion of the joint is then
…show more content…
Post-operative care includes checking the vital sings every four hours or more frequently as needed and reporting any abnormalities to the physician. Aggressive pain management as mentioned earlier is important in patients who have had a total knee replacement. There an accurate assessment of the patient’s pain level is the initial step in the management of pain in these patients. The patient should be advised to report if the pain goal is not been met. It is important for patients who have had a total knee replacement to ambulate early to prevent the formation of deep vein thrombosis (DVT) and pulmonary embolism (PE). Therefore the nurse with the advice of the surgeon and the physical therapy team has to assist the patient to start ambulating soon after the surgery. Also part of the nursing intervention to prevent DVT and PEs includes making sure that the patient is on chemical and mechanical prophylaxis. This will be discussed further in the complications section below. Indwelling Foley catheters are usually placed during a total knee replacement surgery. Part of the nursing intervention will also include making sure that the catheter is removed once it is no longer needed to prevent catheter associated urinary tract infection (CAUTI) (Parker …show more content…
Infection could be prevented by the use of prophylactic antibiotics just before the surgery. Patients who have diabetes have a greater risk of developing joint infections. The signs of infection include fever, chills, pain and swelling of the affected knee. To detect signs of infection early, the patient’s vital signs especially temperature should be monitored closely. It is also important to monitor the knee for any abnormal swelling or discharge. Nursing interventions include regular hand washing and the use of aseptic techniques when changing wound dressings. When joint infection happens they are treated with antibiotics. The patient may also require the drainage of any pus from the joint if there is any (Vera
Baseball players and fans call it Tommy John surgery, after the pitcher who was the first to have the surgery 29 years ago. By any designation, it is one of the major advancements in sports medicine in the last quarter century. Technically it is a ulnar collateral ligament replacements procedure.
Retrieved September 16, 2000 from: http://www. www.sechrest.com/mmg/knee/kneeacl.html. Arthroscopic ACL Reconstruction -. et al. (July 11, 1999).:Arthroscopy.com. Retrieved September 16, 2000 from: http://www.arthroscopy.com/sp05018.htm.
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Maintenance of an appropriate healing environment is also essential throughout the management of diabetic foot ulcers. The choice of dressing is dependent on many factors including presence of infection, amount of exudate and the required frequency of wound bed inspection.
Debate on the superiority of regional anesthesia to general anesthesia continues to date. Current literature does not support any difference in mortality between regional and general anesthesia. The largest randomized study to date highlighting this issue, the General Anesthesia Local Anesthesia (GALA) study group, demonstrated no significant difference amongst patients receiving local versus general anesthesia for carotid endarterectomy surgery45. Following that randomized clinical trial, a retrospective review of the American College of Surgeons National Quality Improvement Program (ACS-NSQIP) reported similar results46. In another report from the ACS-NSQIP focusing on endovascular aortic repair, a lack of difference in mortality amongst local anesthesia, spinal anesthesia or general anesthesia emerged47. Moreover, meta-analyses of regional anesthesia versus general anesthesia for total hip arthroplasty and total knee arthroplasty revealed no difference in mortality.48, 49
The modern total hip replacement was invented in 1962 by Sir John Charnley. Sir Charnley was an orthopedic surgeon who worked for a small hospital in England. The total hip replacement is considered by many to be the most important operation developed in the 20th century, solely based on the fact that it helps to relieve human suffering. Total hip replacement was first performed in the United States around 1969. Since then there have been more then a hundred of thousands of replacements performed in the United States. One of the first surgeons to perform this surgery was Charles O. Bechtol. In 1969, while he was a professor at UCLA, Bechtol started a total hip replacement program. The artificial hip joint is considered a prosthesis. There are two major types of artificial hip joints, cemented prosthesis and uncemented prosthesis. The type of prosthesis that will be used on the individual patient is decided by the surgeon depending on the patient's age, lifestyle and the experience that the surgeon has with a particular one.
These patients can quickly have a change of status and the nurses are there to provide immediate care and assess patients. The nurse will evaluate the patients’ conditions and if they need to go back to surgery for change of status that requires intervention from the surgeon. They also have a crucial responsibility of making sure the patient has a patent airway. The RN will monitor the incisions and observe for signs and symptoms of an infection and will administered pain medications and assess the comfort of
Education of the patient will begin. Depending on the size of the abscess and how extensive the procedure was the patient may need a relative or friend to drive them back home. Not only would the patient need a ride back home, they may need to be watched for 24 hours. As part of pain management pain medication may be given to the patient to decrease pain. Antibiotics may be given to fight or prevent infection caused by the bacteria. The patient will also need to list all medications that they are taking so there will not be any contraindications with the medications that the patient is given. Advise the patient that more than one follow-up appointment will be necessary in order to properly treat the wound. Before the end of the appointment, the medical assistant should give the patient written instructions along with an emergency number and the number to the practice incase the patient has any questions or concerns. Advise the patient to return to the practice if they experience any fever, chills, or the abscess returns. If red streaks appear around the wound tell the patient to call the emergency department immediately. After the the procedure and patient education has been completed, make sure all the step of the procedure has been documented in the patient’s record and all follow-up procedures have been
Because I provide the surgeon with medications, hemostatic agents and irrigation solutions it is crucial to know the proper usage of each, along with the side effects, patient's allergies, and contradictions of certain medications and their reactive
These infections are often associated with improper catheterization techniques. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be caused by improper hand washing, dressing change technique, or improper surgery procedure.
Orthopedic surgeons are responsible for mending and operating on the musculoskeletal system. “Orthopedics is a medical specialty that focuses on the diagnosis, care, and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves, and skin” (Career in Orthopaedics). Depending on the damage the patient has sustained determines how the orthopedic surgeon is able to correct the patient’s injury. In many cases there are multiple ways of correcting the patient’s injury such as; using medical, physical, and rehabilitative techniques to using complex surgical methods. “Typically, as much as 50 percent of the orthopedic surgeon’s practice is devoted to no surgical or medical management of injuries or disease and 50 percent to surgical management” (Career in Orthopaedics). The majority of surgeons, including orthopedic surgeons, prefer to choose the least invasive procedures such as; arthroscopy which is a technological advancement allowing orthopedic surgeons to use special cameras in order to diagnose and treat a joint with minimal cutting and trauma to...
... the first 24 hours, due to anesthesia and pain medications. No strenuous activity and no lifting for two weeks are considered imperative for the recovery. Keeping dressings clean and dry for 48 hours and monitoring for signs of infections and bleeding helps promote a quick recovery.
1.I currently work in the surgical unit and one of the major recovery enhancements is early ambulation after any surgery, especially orthopedic and abdominal. Early ambulation will accelerate the return of bowel function (as evidenced by passage of stool and flatus) reduce the rate of overall complications and decrease the length of hospital stays. Evidence-based practices have shown that early post-operative ambulation contributes to decreased pulmonary complications. “When exploring postoperative activity in the general and orthopedic nursing literature, there is sparse evidence outlining nursing's critical thinking skills associated with decreasing the first postoperative activity from the historical 14-day mark to the most current model of day 1 or 2 for the joint replacement population. Also, there were no recently published reports describing a contemporary
One day, this writer happened to see another nurse changing a Peripherally Inserted Central Catheter Line dressing. As a nurse leader, this writer asked the nurse why she is changing the dressing. The caregiver explained dressing changes can prevent infection to the site and there are lot of patients readmitted because of central line infections and subsequent complications. This nurse demonstrated good kn...
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record