Surgical Nursing Care Total Knee Replacement
Order Description
Background Information
Margaret is a 56 year old lady who lives with her husband.
Due to worsening osteoarthritis Margaret is waiting to undergo a
right total knee replacement (TKR). When Margaret was first
referred to the orthopaedic surgeon, 14 months ago she was told
that due to her weight she wouldn’t be placed on the waiting list
due to both the surgical risks and the expected success of the
operation. At this time Margaret had a body mass index (BMI) of 40
(height 168cm, weight 113.4kg) and was told by the surgeon that she
had to bring her BMI down to 35 (weight 97.5kg) before he would
consider operating. Margaret has worked hard to lose the weight but
is now suffering extreme pain in her right knee which is preventing
her from losing any more weight as her mobility is considerably
restricted. Margaret has seen the orthopaedic surgeon again
following a further referral from her GP. Her BMI is currently 37
(weight 104.3kg) and he has agreed that he will operate on her.
PC: Osteoarthritis right knee, on waiting list for a right
total knee replacement.
HPC: Has been suffering with osteoarthritis in the right knee
since 2011, this has been getting gradually worse and Margaret is
now in severe pain and has a restricted functional ability.
PMH: Morbidly obese
Hypertension
Gastro-Oesophageal Reflux Disease (GORD) Depression
No previous surgical history
DH: Ramipril 5mg OD
Lansoprazole 15mg OD Amitriptyline 100mg nocté Glucosamine (OTC)
Chondroitin (OTC)
No known drug allergies
FH: Father died following an MI aged 67years Mother has CHD,
alive
Has 1 son, alive and well, lives nearby
PSH: Works from home as a book keeper
Lives with husband (Barry, 60 years) who works as a truck
driver
Enjoys socialising with family and friends, although can’t go out as much now due to pain and restricted mobility.
Attends church twice a month (Anglican)
Ex-smoker, gave up 2 years ago (30 pack years) Occasional ETOH
(approx. 6 units per week)
Vital Signs (on referral): Pulse: 84 bpm regular
BP: 146/90 mmHg RR: 19 bpm
SpO2: 98% on room air Temperature: 36.7DC
Part A my response
You are the RN carrying out Margaret’s pre-operative assessment prior to her surgery. Discuss your pre-operative nursing assessment of Margaret. Your response should:
D Discuss any identified risks she poses during the
intraoperative and post-operative period
D Discuss particular actions, assessments, diagnostics or
referrals that may be needed to ensure her safety and well-being is
maintained during surgery and throughout her stay on the ward.
Your response should be evidence-based demonstrated by an engagement with the literature and any relevant guidelines.
Your response (Approx 750 words)
Part B my response
All surgical patients are at risk of developing a surgical site
infection (SSI), however Margaret could be considered at a higher
risk due to a number of factors; including being obese and the
nature of her surgery (orthopaedic joint replacement). Using the
literature critically discuss whether Margaret is indeed at a
higher risk of developing a SSI and present the nursing assessments
and actions to minimise this risk. Your response must be discussed
in relation to Margaret’s case and it must also demonstrate a clear
link to how you will take this knowledge into practice.
Your response (Approx 750 words)
"Are you looking for this answer? We can Help click Order Now"
Other samples, services and questions:
When you use PaperHelp, you save one valuable — TIME
You can spend it for more important things than paper writing.
