Transcript Total Knee Replacement

Total Knee Replacement
Group 3
Barbara Anne Vergara
Edien Negasi
Kossi Kpogo
Mina Chong
Ashley Wells
Total Knee Replacement
• Pathophysiology:
– CAUSE: Arthritis in the knee
– “Arthritis” means 'inflammation of the joint.' Wearing away of
cartilage in the joint -- is the end result of inflammation within the
joint.
• Most common type of knee arthritis is osteoarthritis. This is often
referred to as "wear-and-tear" arthritis
– Results in the wearing away of the normal smooth cartilage until
bare bone is exposed. Other types of arthritis include rheumatoid
arthritis, gouty arthritis, and lupus arthritis.
• Total knee replacement surgery has long been used to treat severe
arthritis in elderly patients.
– However, concerns arise when a patient in his 40s or 50s has severe
knee arthritis that is not relieved with conservative treatments. Once
reserved for elderly patients, total knee replacement surgery is
becoming more common in the younger, active population.
Key Assessments
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Pain – Rate your pain on scale, 0-10
Paresthesia – Tingling?
Pallor- Capillary refill? Mucous membranes?
Polar – Warm to touch? Clammy?
Paralysis - ROM
Pulses – Palpable?
*LABS: WBC- Infection, drainage?
Objective and Subjective Data
Subjective:
• “healthy” on no home medications other than
NSAID
Objective:
• 64 Male
• S/p RIGHT, Total knee Replacement
Nursing Diagnosis
• Acute pain r/tTKR, AEB eight inches (20 cm)
long incision.
• Altered Mobility r/t TKR, AEB use of
wheelchair
• Risk for Infection r/t incision.
• Disturbed Image r/t TKR, AEB, scarring and
decreased mobility overall.
• Impaired Comfort r/t TKR, AEB grimacing.
Outcome/Goal and Outcome Criteria
• Client will rate pain on pain scale. Will take and
follow strict medication regimen.
• Client will do ROM exercises every am for 10 minutes.
• Client will inspect hip incision every day for redness,
heat, or drainage
• Client will demonstrate hip insicion care with mild
soap and water and be sure to dry it thoroughly.
• Client will be placed on high protein and vitamin C
diet
• Client will cough and deep breathe.
Intervention
• Assess VS and pain every hour.
• Assess client’s needs holistically.
• Will assist patient into wheelchair on the day of
surgery.
• Will teach patient to walk up and down the
stairs as needed.
• Assess pain, paresthesia, pulse, polar, pallor, and
paralysis.
• Assess R.O.M.
• Assess infection
Rationale
• To promote healing.
– Systematic ongoing assessment and
documentation provide direction for treatment
plan: adjustments are based on clients response,
(Barry 2006.)
• Prevent Infection
Evaluation
• Client will not experience complications such
as weak peripheral pulses, tachycardia, and
angina.
• Client will verbalize importance signs and
symptoms to report.
• Client will accurately describe recommended
dietary restrictions and medication regimens.
Sources:
• http://orthoinfo.aaos.org/menus/arthroplast
y.cfm
• Nursing Diagnosis Handbook, Ackley, B.