Acute Nursing: Post-Operative Care Plan and Potential Complications

This essay presents an acute nursing care plan for a 63-year-old patient, John Grant, who underwent a bilateral knee replacement. The essay begins with an introduction outlining the aim to apply evidence-based and person-centered care principles. It then discusses two crucial post-operative assessments, including pain intensity and bruising management, along with the importance of regular check-ups. The essay identifies potential complications, specifically post-operative wound infection, detailing its causes, risks, and implications. A comprehensive plan of care is developed to mitigate the risk of this complication, incorporating assessments, diagnoses, interventions, and expected outcomes. Finally, the essay includes a reflection on the process of creating the care plan, referencing the Gibbs reflective cycle to analyze the learning experience and propose future actions. The essay concludes by emphasizing the critical role of nursing staff in patient diagnosis and care, highlighting the importance of systematic treatment plans and reflection to minimize post-operative risks.

Acute nursing

Contents
INTRODUCTION...........................................................................................................................3
Discussion of two comprehensive post-operative assessments..............................................3
Potential Complication...........................................................................................................4
Plan of care.............................................................................................................................5
Reflection...............................................................................................................................6
Conclusion.......................................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Registered nurses refers to the individuals employed in ample number of professional
settings and are mainly specialize in the field of practice. They provide health care services to the
patients and are highly responsible in their recovery. The present essay includes an ability to
execute evidence based principles as well as person centered care for the patient. A client
scenario is given in this essay where the person name John Grant, who is a 63-year-old man got
diagnosed with bilateral knee osteoarthritis. Various issues has been faced by him post-operative
wound infection. In this, prioritizing two main post-operative nursing care which will assist in
preparing a plan for the care of patient.
Discussion of two comprehensive post-operative assessments
John was referred by doctor to have knee replacement and after the operations he is
suffering from plain and many health problems. Therefore, it is important for RN to undertaken
the post-operative assessment. The factors which is need to be consider at the time of post-
operative assessment is given below:
Intensity of pain: After the operation, John feel rousable & is complaining of pain so it
is essential for doctors to intensify the level of pain suffered by the patient in order to provide
them effective treatment (Saviauk, 2018). The pain may sometimes reduced the body function
and the operation recover take time as compare to the estimated time. It is important to
accurately analyse these so pain is managed properly. The systematic nurse-patient
communication is important in order to ensure severe pain that may sometimes associated with
emergency. In addition to this, Nurses are required to evaluate the changes which is occurred in
patient due to pain such as numbness, burning, severe pain and many more.
Managing Bruising and regular check-up: Bruising means the blood gather under the
skin after the surgery or operation and for this the nurses is given blood thinner that help in
preventing deep vein. After the surgery, John has faced a small amount of blood oozing at the
time of dressing so it is essential for nurse to manage this blood oozing timely that help in fast
recovery of knee (Rahimi, 2018). In addition to this, the priority is also given to the regular
check-up of patient as John have not have a balanced blood pressure that is 120/80. Moreover,
the body temperature is also not normal of John after the operations, all this information can be

gained by nurse after the regular check in an effective manner. John also has PCA that is patient-
controlled analgesia that is need to be managed so that the recovery of knee is rapidly take place
in a proper manner.
Potential Complication
There are various complication associated with the operations and can occur after the
operation. One of the complication us wound infection, which is the most common form
occurring within the 30 days after the operation and arise a pain in the human body. It is seen as
localised pain, slight discharge and redness (Vos, Van Putte and Kloppenburg, 2018). The
infection may occur in the body or at the part where the surgery took place. It is important for the
nurse to identify the deepness of wound infection as sometimes it may arise serious problems
and operation is required to manage or decline it. Wound infection sometimes have pus draining
from them & can be painful, red and hot to touch. It also leads to occurrence of fever and the
patient may feel sick. The wound infection is infected by the germs that has already present in
the skin which directly spread to the surgical wound. Sometimes the infected hands of health
care provider or caregiver also occur wound infection in the body. Along with this, there are also
many reasons such as germs in the air, infected surgical instruments, not proper care also leads to
wound infection after the surgery. Therefore, it is important for John and the it’s caregiver to use
clean instruments and surrounded with the clean environment (Wang, 2018). There are various
risk associated with the wound infection that is fluid leaks which may occur with the surgery or
operation. The wound infection mat also cause skin infection that is impetigio and it can turn into
the panful lump, which is called as abscess. Moreover, the ability of human body functioning
may decline and a person is not able to work as effective compare to a non-wound infection
body. One of the major risk associated with the wound infection is cancer so it is essential for
nurses or the person to take care of the infection and focus to heal the infection rapidly as well as
effectively. It is determine that if the infection is prolong and take time to heal can result in
death, which is the major risk, associated with the complication that arise after the operation.
Lack of immunization, not proper circulation, chronic disease are also some of the risk that is
associated with the wound infection.

Plan of care
After examining the overall health condition of the patient, it is required by the medical
professionals and registered nurses to prepare a plan for care. This plan can help them in order
to recover from the post operative infection in an effective manner. Implementation of all the
activities in an appropriate manner by the patient can increase the changes of recovery and
reduce negative impact of the wound arise around the knee area. Along with this, it has also
been observed that after few days of knee surgery, John face acute pain and swelling around the
knee area. After diagnosed by doctors a plan is prepared by them fir their recovery which are as
follows:
Assessment Diagnosis Planning Intervention Rational Outcome
Patient have
observed
post
operative
pain,
swallowing
and redness
around the
knee area.
Acute pain
has been
observed by
John after
knee
replacement
surgery.
Along with
this, a
wound is
arise around
the knee area
As per their
family
observation,
acute pain
has been
observed
which
might affect
the blood
pressure as
well as
temperature
of body in
an adverse
manner.
Doctors
and
registered
nurses
prepare a
plan for
John
which
includes
that they
must clean
up the
wound
with the
help of
medical
staff after
2-3 days
so that it
will
recover as
Assess pain
scale.
Provide quite
and healthy
environment
to the patient.
Assist them
when they do
phyical
activities so
that they do
not get
infected by
any negative
thing.
It is
necessary
to build a
positive
relationship
with
registered
nurses and
follow
every
guidelines
provided
by the.
Along with
this, a date
need to
finalised so
that
comparison
can be
done and
By
implementing
all the things
guided by
registered
nurses in an
effective
manner,
patient will
be recovered
as per the
time
estimated.

after a
month of
surgery.
soon as
possible
and reduce
the
chances of
increase in
infection.
examine
that
whether the
wound get
improved
or not.
Reflection
While preparing care plan for the patient in order to reduce post operative risk, it has been
observed by me that I have learned a lot of things. According to the Gibbs reflective cycle, at the
first stage of Description I have experienced different things, along with this, I have evaluated the
overall experience that what are the good things and what are the negative aspects associated with
this plan. According to the third stage which analysis of the situation, that what might be the impact
on whole condition. Apart from this, a conclusion is drawn about the learning and what can be done
to make the best and different thing. At the end, an action plan can be prepared that how effectively
one can deal with the situation arise in the near future.
Conclusion
With the assistance of above mentioned, it has been concluded that it is very essential for
the nursing staff to diagnose a person in an effective manner before providing them treatment
and care. It has also been identified that there are various types of risk after a patient get operated
and for this, registered nurses are highly responsible. With an analysis it is said that for avoiding
such risk or minimizing the negative impact it is required to prepare a plan for care so that
medical treatment will be provided in a systematic manner to the patients. Along with this,
reflection is also given in this essay which is based on Gibbs model that what are the main
learning and experience get while preparing plan for care.

REFERENCES
Books & Journal
Wang, Y.,and et, al., 2018. Burn injury: challenges and advances in burn wound healing,
infection, pain and scarring. Advanced drug delivery reviews, 123, pp.3-17.
Vos, R. J., Van Putte, B. P. and Kloppenburg, G. T. L., 2018. Prevention of deep sternal wound
infection in cardiac surgery: a literature review. Journal of Hospital
Infection, 100(4), pp.411-420.
Rahimi, R., and et. al., 2018. Laser-enabled fabrication of flexible and transparent pH sensor
with near-field communication for in-situ monitoring of wound infection. Sensors
and Actuators B: Chemical, 267, pp.198-207.
Saviauk, T., and et. al., 2018. Electronic nose in the detection of wound infection bacteria from
bacterial cultures: a proof-of-principle study. European Surgical Research, 59(1-2),
pp.1-11.
Yuwen, L.,and et. al., 2018. MoS 2@ polydopamine-Ag nanosheets with enhanced antibacterial
activity for effective treatment of Staphylococcus aureus biofilms and wound
infection. Nanoscale, 10(35), pp.16711-16720.
Wickramasinghe, N., Gehlot, V., Sloane, E., Smart, P. and Schaffer, J., 2020, January. A
Precision Post-Operative Wellness Monitoring Solution. In Proceedings of the 53rd
Hawaii International Conference on System Sciences.
Theodorou, M.E., Henschen, B.L. and Chapman, M., 2020. The Comprehensive Care Plan: A
Patient-Centered, Multidisciplinary Communication Tool for Frequently
Hospitalized Patients. The Joint Commission Journal on Quality and Patient Safety.
Li, Y., Chen, W., Liu, C. and Deng, M., 2020. Nurses’ Psychological Feelings About the
Application of Gibbs Reflective Cycle of Adverse Events. American Journal of
Nursing, 9(2), pp.74-78.
Online:
https://www.healthline.com/health/total-knee-replacement-surgery/managing-postoperative-
pain#pain-medication