Nursing Case Study on Bilateral Knee Osteoarthritis

HP
Nursing case study
Knee replacement
Microsoft Office User

NURSING CASE STUDY 2
Contents
Contents......................................................................................................................................2
Introduction................................................................................................................................3
BODY........................................................................................................................................3
Conclusion..................................................................................................................................7
References..................................................................................................................................7

NURSING CASE STUDY 3
Introduction
This case study is on63-year-old John Grant who has been diagnosed with bilateral
knee osteoarthritis. He has been experiencing progressive pain, predominantly in his right
knee. Since the pain is less responsive tothe counter pain medications (paracetamol 1g four
times daily) he has been consuming, his general practitioner (GP) recommended him for a
right total knee replacement followed by left knee replacement after complete recovery from
first operation.
Total knee replacement is a surgical procedure usually performed for osteoarthritis,
where a diseased knee joint is replaced with prosthetic knee. Osteoarthritis is defined as a
slowly progressing, degenerative joint condition characterized by deterioration of the joint’s
cartilage, inflammation of synovial tissue and weakness in tendon and muscle and this
breakdown of cartilage results in rubbing of bone against each other causing pain, stiffness
and immobility. When both knees are affected by osteoarthritis it is known as bilateral knee
osteoarthritis (Riddle & Stratford, 2013).
This essay will be describing the pathophysiology of bilateral knee osteoarthritis and
risk factors associated with it. Post-operative assessment undertaken by a Registered Nurse
(RN) will be discussed along with nursing care plan to help him recover from the surgery.
Body
Bilateral knee osteoarthritis, diagnosed in John has various risk factors associated
with it such as hypertension (HTN), type 2 diabetes (T2DM), hyperlipidemia, consumption of
alcohol, etc.John has a history of hyperlipidemia which refers to elevated cholesterol
accumulation. This lipid accumulationcan damage the efflux function of cartilage thereby
inducing osteoarthritis. Similarly, HTN results in narrowing of blood vessels and subchondral
ischemia, initiating cartilage degradation, hyperglycemia in T2DM has direct effect on
cartilage and subchondral bone. This erosion or degradation of cartilage can results in
synovial inflammation and production of proteases and proinflammatory cytokines leading to