Nursing Care for Total Knee Replacement Surgery: A Case Study

Nursing the Surgical Patient 1
Nursing the Surgical Patient
Name of the Author
Name of the University

Nursing the Surgical Patient 2
Introduction
A large number of total knee replacement surgeries performed every year. If a nurse is
assigned for caring a total knee replacement patient pre and post-operation, a background in
evidence-based nursing care will be beneficial. The nurse taking care of such patients must have
skills for assessing strong pain with an understanding of multimodal management of the pain.
This benefits patients in speedy recovery and pain control. Several nursing interventions are
provided to prevent infections or other complications to occur (Parker, 2011). Through this
article, the evidence for the care of a total knee replacement before and after the operation will be
presented. This will represent how safe mobilization and therapy techniques will assist in
keeping the patient safe. This article focusses on a case study of a 74-year-old patient having
right total knee replacement surgery.
Part A
The given case study describes a 74-year-old patient named Frank Wright who was a
retired architect and married person. He had two adult children and his wife had a condition
named dementia. Frank was the only carer for his wife. According to the pre-operative data of
Frank, his height and weight were 170 cm and 92 kgs. He was suffering from hypertension,
which was evident by his BP 140/95 and heart rate 86. According to his medical history, he had
hypercholesterolemia, osteoporosis, and obstructive sleep apnoea since March 2019. He had a
habit of smoking and consume around 10 cigarettes every day. He also had a family history of
heart failure and cancer. As suggested by his current medications, he was taking Simvastatin
40mg nocte, Atenolol 50mg daily, and Ranitidine 150mg BD.

Nursing the Surgical Patient 3
According to the post-operative observations of Frank, BP was 100/54, heart rate 106,
and respiratory rate 12 BPM. The sedation score was 1-2. The blood loss in operation theatre was
estimated at 200ml. After the operation, the medications prescribed to him were Simvastatin
40mg nocte, regular paracetamol 1G QID, Ranitidine 150mg BD, Captopril 50mg BD, Morphine
PCA 1mg bolus, Aspirin 100mg mane, Sodium Chloride 0.9%, and oxygen 2L through nasal
prongs. Additionally, the nurse taking care of Frank must concentrate on his diet and pain
management for better recovery.
After surgery, the main concern of the nurse should be the management of pain as the
pain is unbearable after the surgery of the total knee replacement. When the tissues of the body
damage, it causes pain. Every individual has the experience of pain differently. It can be either
acute, short term or chronic depends upon person to person. The nurse can help the patient by
reducing his anxiety and giving suggestion about the comfortable position to reduce his pain.
The overall recovery of the patient gets affected due to the presence of uncontrolled pain. It
results in the reduction of self-care and mobilization of the patient. Due to this unbearable pain,
the patient gets exhausted frequently and emotionally impaired. After the management of the
pain, another concern for the nurse to take care of the patient’s breathing and initiate ambulation
as early as possible. As Frank has the history of smoking, there are chances of respiratory
complication to arise due to the unrelieved pain. Deep breathing and coughing can become
difficult for him. Pneumonia, lungs dysfunction, hypoxia, and infection are the outcomes of
respiratory complications, which must be considered while treating a patient (Sandika Gedara,
Kauppinen & Louarn, 2015).
Potential Clinical Issues: