Nursing Care Plan 3 Clinical Placement Case Study 2022

Running head: NURSING
Nursing Care Plan 3 Clinical Placement
Student Name
University Name
Student Note

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PART A
Mrs. Renee Martin is an 80-year-old widow, who recently had a knee replacement surgery. Ever
since the surgery, she had been suffering from tenderness and swelling in her calf muscles and
legs. Five years ago, she was diagnosed with dementia, which has progressed drastically over the
period. Considering her psychological condition, she is at a great fall risk after her knee
replacement surgery that she often tends to forget. As a result, there have been several scenarios,
where she has tried to walk at a faster pace, causing her to fall, and leading to bruising on her legs
and arms. Due to the frequency of her falls, the symptoms of deep vein thromboembolism went
unnoticed by her doctor, causing her to become more and more agitated with pain on her legs.
Due to frequent complaints of severe pain in leg and calf muscles, she was admitted to the
hospital.
Age :
Risk: Age is considered as one of the most important risk factors of neurodegenerative diseases
like dementia. It has been seen that dementia is most common in age range of 65 to 90. This
disease progresses as years go by, deteriorating the memory retention capacity of the patients.
Management: The best way to manage a dementia patient is by understanding the different
behaviours of the patient. Dementia unlike Alzheimer’s is curable and thus medications like
donepezil and memantine can help reduce the effects of this disease.
Anaesthesia and surgery
Risk: This case subject, Mrs Martin has suffered from a condition of formation of blood clot in
her legs due to the improper conduct of her knee replacement surgery.
Management: Healthcare providers like nurses and doctors should ensure the proper execution of
surgeries in order to prevent cases like this. Studies have observed that general anaesthesia in
cases of knee replacement surgeries prevents after surgery complications like clot formations or

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increased pain or swelling.
Cognitive status
Risk: As a dementia patient, who is not yet taking any medications of for this disease, she is
bound to lose control over the basic cognitive skills like thinking and remembering, eventually
leading to cognitive impairment.
Management: Ensuring she takes medications like donepezil and memantine, timely and in right
doses.
Deep vein thrombosis, venous thromboembolism, pulmonary embolism
Risk: In these conditions the blood clot formed can reach the lungs causing respiratory
complications.
Management: Compression stockings and blood thinner medications like warfarin and heparins.
Immobility & pain
Risk: The pain from the deep vein thrombosis and knee surgery can make the individual very
agitated and given her condition, it will become harder to contain her. This can also affect her
sleeping pattern as the pain might not allow her to sleep properly.
Management: Pain killers and blood thinners can be prescribed.
Length of stay
Risk: In the hospital, she might need to stay for 6-10 days, given her age and decreased healing.
After release, she would require an assistance for her safety.
Management: During the length of her stay as well as her prolonged recovery period, she would
require assistance regarding the execution of her day to day activities.
Mental health condition
Risk: She tends to forget easily due to her dementia.
Management: Dementia unlike Alzheimer’s is curable and thus medications like donepezil and
memantine can help reduce the effects of this disease, and enable the stabilization of memories.

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Nutritional status
Risk: During the recovery period, she would require to eat a low fat diet.
Management: The nurses should provide the patient with a calcium rich, low fat diet along with
vitamin supplements.
Presence of morbidity, & non-compliance
Risk: Due to her dementia she often forgets to take her medications, and even eat, causing
detrimental effects on her health.
Management: Administering a personnel care giver to ensure that the patient eats food and takes
her medications timely.
Maintaining a safe environment, including risk prevention strategies:
 Providing safety companions to prevent trips and falls.
 Low- fat diet to prevent weight gain during the recovery time for knee replacement
surgery.
 Physiotherapy training to prevent complete immobilization of the patient.