Total Knee Replacement

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

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).

The first short-term goal is to decrease obesity. Interventions for this goal are nutrition education, weight loss programs, and increasing physical activity. The second short-term goal is to decrease the incidence of hypertension. Interventions for this goal are regular blood pressure screenings, treatment of people with hypertension, and improve medication access. The third short-term goal is to decrease cholesterol. Interventions for this goal are regular cholesterol screenings, diet education regarding high risk foods, and treatment of people with high

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.

In Kindred Rehabilitation, the patient had a total knee replacement due to osteoarthritis. Osteoarthritis causes degenerative changes, within the joints causing bone stiffening and reactive inflammation. My patient was admitted on 10/21/11 with osteoarthritis and a left total knee replacement. Her PT and INR were a concern because she had developed mild thrombocytopenia which resulted in the elevation and potential bleeding. The physician had to take her off of Lovenox and switch her to an oral anti-coagulant Xarelto at 10mg once daily. During her care I was educated by the interdisciplinary teams managing mobility, safety, and the more

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.

In July 2015 there was a proposal issued for a new Comprehensive Care for Joint Replacement program. This proposal is designed to establish bundled payments fir total hip and knee replacements. The program for Comprehensive Care for Joint Replacement (CCJR) is a crucial development for Medicare and Medicaid holders.

Nifedipine is a calcium channel blocker which can be used alone or in conjunction with other medications for treatment of angina and hypertension. It decreases the contractility of the arterial smooth muscle as well as the subsequent vasoconstriction through inhibition of calcium ions influx through the L-type calcium channels. As a result, the coronary and systemic arteries become dilated and the delivery of oxygen to the myocardial tissue is increased. Furthermore, the total peripheral resistance is decreased as well as the systemic blood pressure and afterload.

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.

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.

It is important to note that the adverse events experienced by the nifedipine receiving group were easily controlled and were all treated in an outpatient setting. No

Patient satisfaction is the ultimate goal of all orthopaedic procedures. Total knee arthroplasty (TKA) has revolutionized the care of patients with end-stage knee arthritis. In spite of significant advances in primary TKA, various studies show that only 82% to 89% of primary TKA patients are satisfied. In this paper this issue is re-examined after primary TKAs performed in the province of Ontario. The patient population, the overall level of satisfaction and the number of preoperative and operative factors that affect patient satisfaction and dissatisfaction are important topic to consider comparing with previous study.

Nitroglycerin avoids hepatic first pass metabolism by sublingual administration used in emergency. T-half is 10 minutes and anginal symptoms will return as it metabolized. Nitro-bid is an oral or topical preparation are metabolized by liver allowing prolong bioavailability. Isosorbide mono nitrate and isosorbide di nitrate are long acting nitrate because of hepatic catabolism resistant (t-half= 1 hour). The main adverse effects of nitrates are throbbing headache, flushing of the face , dizziness especially at the beginning of the treatment, and postural hypotension due to pooling of blood in the dependent portion of the body. As they are contraindicated in renal ischemic conditions, acute myocardial infarction patients , and patient receiving antihypertensive agents and

The purpose of this report is two discuss the Pharmacodynamics, pharmacokinetics, proposed benefits, research method, results of research, and possible-nursing implications of newly approved drugs for the treatment of hypertension. These drugs include Atacand HCT and Diltiazem HCL. All newly approved drugs from the FDA are either new drugs or new formulations of older drugs. The information contained in this report was derived from various web pages and online search engines.

At the outset of treatment, the patient and health care provider should discuss and agree upon goals. The goals must take into account the food habits, exercise behaviors, psychological outlook and support systems of the individual. Realistic expectations, short- and long-term, may be promoted by a discussion of a healthy weight versus an ideal body weight. Features of weight management