Nursing the Surgical Patient: Care Plan, Clinical Issues, and Discharge Plan

Running Head: NURSING THE SURGICAL PATIENT
Nursing the Surgical Patient
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NURSING THE SURGICAL PATIENT1
Introduction
The knee replacement surgery can also be defined as knee arthroplasty. It is defined
as a surgical process exploited to replace the weight bearing surfaces of the knee joint
(Namba, Inacio & Paxton, 2013). This facilitates relief from pain and disability of the
individual undergoing this surgery. Based on the evidence-based literature studies it can be
stated that post the knee replacement surgery individuals can get back to their routine life and
perform the required daily activities in almost six weeks gap (Healy et al., 2013). But it
should also be taken into account that the knee arthroplasty is a painful surgery that requires
effective wound healing and the healing process can encounter challenges like swelling and
inflammation and fever in an extreme level due to the pain (Lamplot, Wagner & Manning,
2014). An effective plan for the care after the knee replacement surgery promises successful
healing and has minimum complications involved.
This article is based on a case study of Frank Wright, 76 years of age who underwent
a right knee surgery and the subsequent care plans required by him to ensure fast recovery.
He has a past medical history of hypertension and hypercholesterolemia as well. He also has
sleep apnoea. He smokes cigarette and has a minimal alcohol intake that should be
considered. This article enlightens on the care plan for Frank and also discusses on the
negative health impact of substance abuse and also interfere with the healing process.
Part A: Plan of Care
The observable vital signs exhibited by Frank Wright post his knee replacement
surgery included low sedation score, low blood pressure and there was slight temperature.
The agitations due to pain can be the cause of the low sedation score of 1-2. His blood
pressure was also 100/54 mm Hg. Other vital signs that included the respiration rate was
normal of 12 breath per minute.

NURSING THE SURGICAL PATIENT2
Frank Wright has low sedation score and it has been observed that night pain is
common post the knee replacement surgery. Morphine is administered to Frank Wright to
reduce the pain. Morphine is a pain medication and this drug belongs to the opiate family.
Morphine is a drug that directly acts on the central nervous system of the individual to reduce
the feeling of pain. It works on the brain and modifies the feeling of the body and
consecutively responds to the pain. Cryotherapy was also exploited to manage the pain but
the tolerance level of the patient was also taken into consideration. This is a pain treatment
that exploits the method of localized freezing temperatures to soothe and deaden an irritated
nerve. He is prescribed comfeel dressing that is exploited to manage the low to moderate
level of exudation from the wounds post operation.
Frank Wright has been administered with100 mg of aspirin to prevent unnecessary
clot formation. This medication aids in thinning of the blood since Frank Wright had the
medical history of hypercholesterolemia. Thinning of the blood prevents clot formation at
unwanted places. Formation of blood clots deep inside the legs after the surgery is also called
as deep vein thrombosis (DVT). Injury and surgeries increase the probability of blood clot
formation. Formation of blood clot should be considered as a serious risk factor that should
be controlled and prevented at highest priority. When normal clots form the blood cells and
the factors aiding in the clotting process work together to form a protective scab on top of the
healing wound. But some of the clots form at unwanted places in the body leading to
blockage of the normal blood flow and increasing the chances of DVT formation. It is often
observed that deep vein thrombosis can occur without any observable symptom and it is
challenging to detect them in some cases. Hence, doctors resort to preventive measures
without taking a chance to prevent the occurrence of the deep vein thrombosis in case of
lower extremity surgery like total hip or knee replacement surgery. Simvastatin is also