TOTAL RIGHT HIP ARTHROPLASTY OBSERVATION 2
Total Right Hip Arthroplasty Observation
On April 11, 2014, I had the privilege of direct observation of a patient’s orthopedic surgery, from the pre-operative to post-operative setting. The patient with the initials N.R, which we will call Mrs. R, arrived to the hospital just prior to 6:30a.m. As the name implies, Mrs. R was a female patient, 76 years old with an admitting diagnosis of right hip osteoarthritis. Due to arthritis in her hip, Mrs. R’s ability to perform daily activities and participate in hobbies such as dancing has been extremely compromised over the last 2 years. The overall goal of Mrs. R’s surgery
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Once the head of the femur was removed, a drill was used to create a canal in the femur; this allows the femoral stem to be placed. The head is then connected to the same femoral stem. The small head is the replacement for the original femoral head which was the site of the osteoarthritis. Next an acetabular shell made of high molecular weight polyethylene is inserted into the acetabulum of the hip bone. The acetabular shell and femoral head articulate with one another and comprise Mrs. R’s new hip joint (United States Library of Medicine, 2013). The purpose of this surgical follow through paper is to discuss Mrs. R’s experience as she moves through four different clinical experiences or phases that make up her surgical procedure. The phases Mrs. R will move through consist of her pre-operative clinical experience, her intra-operative clinical experience, her recovery room clinical experience, and finally her post-recovery room …show more content…
She will need to be taught the basic mechanics of using the walker especially on stairs, since she has 3 stairs to get into her house and a couple within her house. For safety purposes the therapists will need to teach Mrs. R how to navigate both up and down these steps. Second, Mrs. R might need a bench to sit on while taking a shower (once allowed) or be taught how to get in and out of a tub shower with this same bench inside for her to sit on. Navigating over the side of the tub might be challenging for Mrs. R especially if she has no assistance, since most of her family lives in Georgia. Most importantly Mrs. R will have to accomplish all of this without flexing her new hip more than 90 degrees causing a dislocation which is a potential complication after a hip surgery (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011, p
For the duration of my surgical follow through experience, I had the pleasure of following RF. RF is a 49 year old male with an admitting diagnosis of cervicalgia cervical herniation, and a scheduled surgery for an anterior cervical discectomy and fusion at C4-C5 and C6-C7. According to Sharon Lewis in “Medical Surgical Nursing”, the cause of a cervicalgia cervical herniation is “the result of natural degeneration with age or repeated stress and trauma to the spine.” (Lewis, 2011) The follow through process was observed from when the patient arrived in the pre-op holding area until the
S.P. should be up out of bed post-op day 1 and wearing TED hose continuously, as well as wearing SCDs overnight in bed. Constipation prevention should e achieved by administering scheduled doses of Colace. Proper nutrition should be encouraged to include plenty of protein to ensure proper wound healing and avoid development of pressure ulcers (Lewis, Dirksen, Heitkemper, Bucher, & Camera, 2011). S.P. should practice coughing and deep breathing throughout her hospital stay to avoid lung congestion and occurrence of pneumonia infection, educating the patient about smoking cessation assistance can be helpful as well.
When she sees a patient for the first time she talks to them about the doctor’s report and asks specific questions about their injury or experiences leading up to the need for physical therapy. Megan explained how important it is to make the patient feel comfortable and keep a positive attitude towards the patient’s recovery. These consultations were the most interesting to sit in on because it allowed me to observe the therapist’s ability to take the patient’s information and create a diagnosis and treatment plan for the injury or pain described. Megan may have multiple patients at a time so she stressed the importance of keeping up with each patient and why the physical therapy techs are so helpful. Scheduling is another job of the therapists that is important in keeping the clinic running smoothly. There is also paperwork that has to be filled out for every patient after every visit about their
The bone structure of a normal hip consists of an acetabular and a femoral head, which is covered with articular cartilage, a smooth and strong cover. There is then a ring of cartilage which is called the acetabular labrum. This provides stability, maintains joint fluid pressure and distributes weight to the femoral head. With poor coverage of the femoral
Murakami has experienced several barriers to achieving independence based on her medical history. Within this paragraph, I went over Ms. Murakami hobbies, interest, and culture, as well as some suggestions into how she can still continue with these activities, in the hopes to make her new long-term residency as comforting to her as possible. As an avid walker, Ms. Murakami diagnosis of osteoporosis has restricted her from regular exercise. It is important that the maintenance of the incision site and surrounding tissue is monitored, in addition to PT and light exercise regimen are done daily in order to help Ms. Murakami achieve her fullest range of mobility. Ms. Murakami enjoys gardening, landscaping, and crocheting. If possible, a small gardening spot should be given, as well as yarn for her to crochet; keeping in mind any aids that she will need in order to be independent. Ms. Murakami has won numerous photo contest awards and should be given a camera to allow her to continue with her hobby. By having the garden close to her window, Ms. Murakami could sit in her room comfortably while taking pictures of wildlife within sight of nursing staff. Being a Japanese Canadian, I feel it is utmost important for Ms. Murakami to be able to practice her culture regularly. Providing Japanese books, TV shows, and movies would be appropriate. Ms. Murakami worked as a librarian for many years, therefore by providing books and the potential of working in the library in your facility
Many patients admitted to the stroke and orthopedic rehabilitation unit have impaired physical mobility. The length of time in rehabilitation is ten to fourteen days. Many times nurses, patients and family members form bonds that last long after the discharge. I recently had the opportunity to take care of a patient I will never forget. Mrs. C was admitted to the rehabilitation unit following recent hip surgery. She is eighty years old and had fallen raking leaves in her front yard. Mrs. C has a history of hypertension, arthritis and gout. Medications include aspirin, metoprolol and allopurinol as needed. Prior to admission Mrs. C lived independently and has two children who checked on her routinely. No cognitive or mental deficits are noted. Key parts of this paper include the introduction, NANDA, NIC and NOC elements, data, information, knowledge and wisdom and the conclusion.
After evaluation, Suzy needs assistance to set up and move from wheelchair to bed. She can stand, pivot with assistance, and is cooperative. She is about 5 feet tall and weighs about 100 pounds. Explaining the procedures is important for the resident to understand what will be done and how (Anon., n.d.). After explaining procedures and ensuring Suzy understands, place right arm under shoulders, left arm over legs, gripping Suzy's right knee, bending and bracing knees against the and keeping back as straight as possible to avoid injury, using
Dr. Cox has served as the team physician for St. Mary’s College Seahawks as well as the Chief of Surgery and Board Member at St. Mary Hospital. He offers the residents of Southern Maryland a variety of orthopedic services. Dr. Cox specializes in treating disorders of the hip and the knee. He has experience repairing the Anterior Cruciate Ligament (ACL), rotator cuff and meniscus by means of arthroscopic surgery. His passion is precision customized total knee replacements and every aspect of accelerated recovery following a joint replacement; therefore, he performs partial and total knee replacements using ConforMIS Knee Implants. These state-of-the-art implants provide patients with a custom-made implant that is designed specifically to meet his or her unique anatomy.
Remove the femoral head and replace it with a prosthetic ball and stem secured into the top of your femur.
As for my family’s perspective, this is going to be mainly based on my mom’s friend’s perspective. His expectation of entering Walt Disney World Magic Kingdom was not to wait in extensively long lines, to be selected randomly to go through metal detectors, be detained for ten minutes, and then must explain his medical history because his hip replacement created the metal detector to be activated. His first encounter with Walt Disney World cast members created the term “moment of truth” and this first approach between him and the cast member security gave a negative effect on my mom’s friend. He was expecting a magical service experience, everything he has seen on television; however, he felt he did not receive this type of expectation,
The objective of this reflection is to explore and reflect upon a situation from a clinical placement on an orthopedic unit. The incident showed that I did not provide safe, timely and competent care for my patient when the oxygen saturation was low. Furthermore, this reflection will include a description of the incident, and I will conclude with explaining what I have learned from the experience and how it will change my future actions.
During the treatment session, the therapist introduced the client a hip kit, which consisted of a reacher, sock aid, and dressing stick. The purpose of the therapist introducing the hip kit was for her to promote independent dressing, specifically donning on/off socks. Also, the therapist had to adhere to the hip precautions as stated in the client’s medical chart. As we observed the client using the tools for their time, they have expressed frustration and difficulty in completing tasks. However, the client was able to independently don on/off their socks through verbal cues. The client asked both of us why the hip kit is necessary, and we replied that it will help them maintain their independence, as their goal is to return to their life prior to their injury.
Methods: Seventy patients with a unilateral ACL-deficient knee were randomly assigned to 1 of 2 femoral fixation groups. Group A (35 patients) was fixed with 2 bioabsorbable Rigidfix pins, 1 cross-pin per bundle, while group B (35 patients) was secured with
Case involves a 60yr old man who underwent an uncemented total hip arthroplasty or a total hip replacement, who was referred to a home PT upon d/c instructing the patient to start home PT & begin ambulation using the ‘toe touch weight bearing’ which was incorrectly mentioned in the d/c summary as ‘weight bearing as tolerated’. For the initial 6 weeks, a patient with uncemented prosthesis should begin with ‘toe touch weight bearing’ and not ‘weight bearing as tolerated’ unlike the cemented prosthesis1. Toe touch weight bearing is instructed to the patient to protect the joint & also give bone the time to grow into the porous coating of the implant2. During the patient’s visit, the PT developed a plan of care from his evaluation & examination and handed-over the case to the PTA to carry out the therapy interventions. PTA (Physical Therapy Assistant) is defined as an educated individual who works under the direction & supervision of a physical therapist3. From the mentioned case, it is clear that the PT has not read the d/c summary and also that he has not mentioned the type of prosthesis used whether a cemented or an uncemented which highlights the PT’s failure of proper documentation. PTA has elected to follow a plan of care that she felt was consistent with that of a cemented prosthesis, highlighting the PTA’s mistake because the PTA is not allowed to make any modifications and follow the plan of care as directed by the supervising PT. PTA is not being periodically
Mrs Smith, 5 days prior to visiting hospital tripped and fell, her injury’s prevented her from standing up. At hospital she was diagnosed with a left fractured neck of the femur (L NOF) and required an immediate left total hip replacement surgery. Mrs Smith is 85 years old, lives with her husband at home, has no children however has a strong social support network through her church. She is involved in her community and continues to teach piano. Mrs Smith only known medicine issue is urinary incontinence. 10 days’ post-surgery Mrs Smith developed a urinary tract infection increasing her length of stay in the hospital. This led to the diagnosis of delirium, worsening of her continence issues impacting negatively on her mental health. This has resulted in slow progress in mobility and delay of her rehabilitation plan. Mrs Smith’s anxiety levels are heightened as she is fearful of falling again and is concerned whether she will be able to return home as her mother passed away shortly after she broke her hip. This case study will examine if Mrs Smith will be able to return home with an effective management & discharge plan based on a multidisciplinary team using a person centred approach. The treatment plan will endeavour to assist Mrs Smith to return home. A full health, coordination and function analysis is scheduled to assess to identify any underlying medical condition and possible risk factors for further falls.