Knee Replacement Procedure

A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today. The patient is checked in at admitting and is called back to the pre-operative area by the nurse. The patient changes and the nursing staff begin to take the patient’s vital signs, review the patient’s history, draw blood for lab work and they let the patient know what to expect before, during and after surgery. The surgeon arrives and checks in with the patient, asks if they have any final questions before surgery and then leaves for the operating room to prepare. The patient is taken to the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and the patient is taken to the post-op area. When the patient comes out of the anesthesia, the surgeon

The first 10-14 days after surgery is focusing on keeping the wound dry and clean, being able to straighten the knee, and being in control of the quadriceps. The knee is also iced often to keep swelling and pain down. During physical therapy the focus is on keeping the kneecap mobile, regaining full range of motion, getting strength back to the quads and hamstrings, and regaining balance. Mobility stretching can include; knee extension and flexion which is just bending and straightening the knee, hamstring stretching, that is extending the leg and reaching for toes, and groin stretches, extend both legs as far as you can and lean forward. Strengthening exercises are lunges, squats, leg presses, step ups, calf raises which is going on your toes, hamstring curls lay on your stomach and bend the knee, hip adduction use a resistive band and pull the leg across the body, for hip abduction just pull the leg across the body again against the resistance while keeping the knee

A total knee replacement (TKA) is the most common joint surgery performed in the United States (Turner, 2011, pp. 27-32). Each year, over 650,000 Americans undergo this surgery (Wittig-Wells, 2015, pp. 45-49). It is an invasive surgery that involves an incision on top of the knee and replacing damaged parts of the knee with artificial parts that are either metal, ceramic or plastic. Someone would get a total knee replacement for damage of the joint, osteoarthritic, posttraumatic, or inflammatory arthritis. The cartilage is damaged, wears away and then you develop bony deformity and contracture of ligaments but it starts out with specific defects or wear of cartilage. The top nursing priorities for a total knee arthroplasty is to “prevent complications, promote optimal mobility, alleviate pain, and provide information about diagnosis, prognosis, and treatment needs” (Doenges, 2014, pg. 627). A possible nursing diagnosis from the patient who is undergoing a TKA might be ‘impaired physical mobility related to pain and discomfort as evidenced by reluctance to attempt movement.’ Another one could be ‘acute pain related to chronic joint disease as evidenced by reports of pain’ (Vera, 2014).

Oliver et al. (2014), exemplifies how some physicians may not be aware of their implicit bias that could be causing healthcare disparities. This study determines whether physicians’ implicit racial views of African Americans affect their decision making, regarding total knee replacement (TKR) as a treatment option for OA. They also assessed whether not, if the Racial Implicit Association test would impact TKR recommendations. In the study implicit bias was determined by the racial implicit association test (IAT) and explicit bias was tested using a questionnaire that asked physicians which race they preferred (black or white) using a 5-point Likert scale and 10-point thermometer scaled to grade physician’s feelings.

The agenda was quite clear that during their observations the recovery showed needs were decreased according to age and BMI. They stated older patients were in need of more assistance and longer stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with bilateral knees had decreased needs and that unilateral were in need of more assistance before discharge. Managing pain was their first priority during research and rehabilitation, followed by instructing care of their own surgical wound. The aim of this study was to actively reinforce assessment and management after this procedure and giving guidance to those in health care.

I will be taking sick leave tomorrow, Monday, January 9, 2017, so I can pick-up my mother from the hospital in Winchester, VA. She had knee replacement surgery this past Thursday and she is scheduled to be released around noon tomorrow. I also need to get her prescriptions filled, so it will be a full day.

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

Enhanced recovery after surgery (ERAS) are a relatively new set of protocols arising in the 1990’s which have since been coined the gold standard in surgical patient care. They have been increasing adopted in because overall research has shown them to be a safe and cost effective way of reducing length of hospital stay and positive patient outcomes. ERAS protocols are threaded throughout the perioperative care, including pre, intra and post-operative phases. I will analysis two research papers which highlight the use of ERAS protocols and define a variety of protocols and focus on four ERAS protocols which are commonly used in surgical nursing.

Getting a total or even a partial hip replacement in Frisco, TX is a major surgical event, and the process of deciding whether or not to have a the procedure performed is an even bigger decision. Perhaps the most daunting aspect of getting a hip replacement in Frisco, TX is the recovery time that is necessary following the surgery. If you're not sure whether or not it may be time to tackle this kind of major surgery, here are some of the signs you should be looking out for.

Another concern that some patients may have is that recovering from this procedure will be extremely lengthy and painful. However, this is usually not the case, and patients should expect the worst soreness from this procedure to start subsiding within a few days of the procedure. If you notice the pain worsening or discoloration starting to show, you should immediately contact your doctor because this may indicate an infection has developed.

You'll be in pain after your knee surgery, and you'll probably be sent home on pain medications to keep you comfortable. If the medications make you groggy, you may develop irregular sleeping patterns that interfere with taking other medications on schedule. If you need to take antibiotics or medications for a condition such as diabetes or high blood pressure, you need to take the drugs on time. A home health nurse or aide will make sure you take your medications on time. He or she can also supervise your medications to make sure you take the right dosage since you may have fuzzy thinking due to pain and narcotic medications.

Total knee replacements are known as the most effective orthopedic procedures in the world. These surgeries are most often preformed on geriatric patients. Over time, because the knee is one of the lowest joints in the body, it is typically more prone to wear compared to joints holding less body weight. In the United States, the overall amount of total knee replacements exceeds over four times the overall number of total hip replacements. In the year of 2015, the estimated number of total knee replacements was predicted to be about 719,000 ("Inpatient Surgery." Centers for Disease Control and Prevention). Ordinarily knee replacements are used to ease pain and disability caused by arthritis or other joint problems, while preserving movement.

In a hospital I worked at recently, I was told in report that a patient I was taking was demented and didn’t know where she was or what her situation was. The patient admitted for a post knee replacement was 86 years of age, fragile, very hard of hearing and mute. The pain in her knee was excruciating and she often cried out asking for pain medication. Moving her in the bed also caused her pain, because she was said to have dementia no one explained to her what they were doing so, she fought the staff when they moved her or changed her brief. After I came on shift I assessed her, I attempted to take her knee immobilizer off to assess her knee and she cried out in pain and smacked my hand aside. I felt so bad for her, I decided to try to yell

Your health care provider may recommend that you limit physical activity for a few days after the procedure. Ask your health care provider what activities are safe for you.

People undergo total knee replacement when arthritis or injury erodes the joint's natural cushioning to the point where it's hard to walk even short distances without severe pain.