Acute Care Nursing: Assignment
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Added on 2021-05-30
Acute Care Nursing: Assignment
Added on 2021-05-30
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Running head: ACUTE CARE NURSINGACUTE CARE NURSINGName of the UniversityAuthor Note
1ACUTE CARE NURSINGTopic- The patient is to undergo a total hip replacement for severe debilitating osteoarthritisIntroductionOsteoarthritis is one of the commonest form of arthritis and it is a debilitatingcondition that is normally characterized by pain, inflammation, stiffness of the joints that canlead to substantial degree of disability in the elderly people. It is mainly caused by thedegradation of the collagen and proteoglycans in the cartilage. Hip arthritis often deterioratesso much that the painful hip joints have to be removed surgically and replaced with anartificial joint (Park, Koehle & Deveza, 2016). It is mainly done when other treatment optionslike medications or other complementary treatments fails to provide necessary relief.However, a wide array of preoperative and post-operative precautions has to be taken to ruleout the complications of the infections, blood clotting, bleeding, fluid volume deficit and jointdislocation (Magee, 2013). This paper will discuss about the pre and the post-operativemanagement of a patient undergoing hip replacement surgery. Preoperative management of a total hip surgery due to debilitating osteoarthritisPhysical examination included the assessment of the strength of the muscles and themeasurement of the lower extremity. The range of hip motion, was measured in degrees andthe strength of the muscle is assessed by the Lovett’s scale (Czyżewska et al., 2012). At thetime of the physical examination, the primary care provider will be evaluating the currenthealth status of the patient. Preoperative education can be referred to any kind of education that is deliveredbefore the surgery for improving the knowledge, health behaviors and the health outcomes(McDonald et al., 2013). Preoperative education regarding exercises, diets and continuation
2ACUTE CARE NURSINGor the discontinuation of medications is related to better medical outcomes. Preoperativeeducation results in fewer adverse effects like deep vein thrombosis. The nurses can assist thepatient to practice deep breathing exercise, as deep breathing will help to use the abdominalmuscles and the chest muscles (Gill & McBurney, 2013). The nurse can also help in effectivecoughing and that helps in keeping the airways clear. It is necessary to discuss about the post-operative pain control techniques such as the patient controlled analgesia (McDonald et al.,2013). The client should have a clear knowledge about the purpose of the pain control inorder to permit early movement and any sorts of complications. It is necessary to teach aboutthe preoperative preparation of the skin such as shower and skin scrubs. This preventsinfection through surgical site (Czyżewska et al., 2012). Seven days before the surgery, it is necessary to stop continuing all the NSAIDsmedications like naproxen or ibuprofen as they interfere with the blood clotting and canincrease bleeding at the time of the surgery. If the patient is on the blood thinners, it isnecessary for the doctor in charge to guide the patient as of how long before the surgery, themedication should be stopped (McDonald et al., 2013). Seven days before the surgery it isadvisable to stop most of the supplements like Vitamin E or fish oil as many people take fishoil supplements for pain relief. It is all right to take Tylenol or cerebrex until the day of thesurgery. Physiotherapy is recommended for the management of the osteoarthritis in thepreoperative period. Czyżewska et al. (2015), have recommended certain preoperativeexercises before the hip replacement surgery, such as the bed mobility exercise, sitting kicksor the long arc quads and chair push-ups. Straight leg exercise and abduction sets often helpsto tighten the muscles of the thighs (Bandholm & Kehlet, 2012). Dental evaluation is necessary before the surgery. Systemic spreading of theperiodontal bacteria through the blood stream may cause infection on the artificially placed
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