Diagnosis Of Post Operative Nursing Interventions

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Total Hip Replacement Introduction Ms Sue Pink a 75 year old widow presented in orthopaedic ward following a fall at home resulting in an intra-capsular fracture of the hip at the femoral neck. She has a history of severe rheumatoid arthritis, had an upper GI bleed in 1993 and had coronary artery disease bypass graft 9 months ago. In this essay I will discuss the entire continuum of post-operative nursing interventions in the first 24 hours with more emphasis on pain management for Ms Sue following Total Hip Replacement (THR) Pathology There is a high prevalence of degenerative joint conditions such as osteoarthritis among the older adults. Moreover this debilitating condition make them…show more content…
It is imperative for the nurse to identify patient’s post operative needs and potential problems so as to provide support and counselling specific to individual (Hordam et al 2011). Thus the focus of assessment is considering the main dimensions of patients situation after THR. After surgery a comprehensive assessment of Ms Sue’s condition and observation has to be conducted thoroughly, considering post- operative orders and complications. Diagnosis is based on complete history, physical examination, laboratory and X- ray findings. r Swearingen ,(2012) describes number of post operative assessments in the first 24 hours after THR that are critical for patients recovery. Firstly assess Ms Sue’s pain for severity and as per protocol administer Hydromorphine 25mg intravenously by PCA pump. Also administer methotrexate (2.5mg/week) for relieving joint inflammation and pain. Monitor the patient, evaluate the effectiveness of analgesia and ensure patient is alert and oriented. In addition assess the surgical site and wound dressing. The evidence suggests that a semi-permeable film dressing such as Tegaderm may be preferable as it allows nurse to visibly inspect wound (Lucas, 2008). To reduce postoperative risk of infection prophylactic IV antibiotics such –Cefazolin 100 mg IVq8hx3 doses may be administered to prevent any bacterial infection. Monitor for elevated temperature, purulent drainage, increased pain and signs of sepsis at the surgical site. Secondly
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