Arthroplasty Care

Specific Arthroplasty Care: Care after Total Knee Replacement

  • To reduce swelling, elevate the affected leg as ordered.
  • Quadriceps exercises and straight leg-raising can be initiated by the patient when ordered by the physician. These activities are usually done on the first postoperative day. Usually, after the first dressing change, flexion-extension exercises can be encouraged to be done by the patient when ordered.
  • If CPM machine is ordered, the practitioner will adjust the machine daily to increase the degree of flexion of the affected leg gradually.
  • Weight bearing status and the degree of flexion and extension depend on the practitioner’s specific orders, surgical approach used and the preferences of the surgeon.

Arthroplasty Care: Special Considerations

  • Explain the procedure to the patient before the surgery. This helps gain patient cooperation and at the same time letting the client know what to expect during and after the procedure.
  • Inform the patient and give emphasis on the frequent assessment needed including vital signs, neurovascular integrity and wound drainage. Let the patient know that these procedures are normally done after the operation.
  • Tell the client that he will be receiving an IV of antibiotics for 2 days. Make sure that the client understands the reason of medication administration round the clock.
  • Explain the need for immobilization of the affected leg and mobilization of the unaffected leg.

Arthroplasty Care: Possible Complications

  • Pulmonary embolism
  • Pneumonia
  • Phlebitis
  • Paralytic ileus
  • Urine retention
  • Bowel impaction

Arthroplasty Care: Health Teaching (T-E-A-C-H)

T – Tell the patient not to drive after the 2-month follow-up.

E – Encourage and teach the patient to perform muscle strengthening exercises for the affected and unaffected extremities to maintain muscle strength and ROM to prevent phlebitis.

A – Advise the patient that he or she may return to work in 3 to 6 months or per physician’s instructions.

C – Coach the patient about home care and exercises before discharge.

H – Have the patient wear the elastic stockings until the two-month follow-up.

 

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Daisy Jane Antipuesto RN MN

Currently a Nursing Local Board Examination Reviewer. Subjects handled are Pediatric, Obstetric and Psychiatric Nursing. Previous work experiences include: Clinical instructor/lecturer, clinical coordinator (Level II), caregiver instructor/lecturer, NC2 examination reviewer and staff/clinic nurse. Areas of specialization: Emergency room, Orthopedic Ward and Delivery Room. Also an IELTS passer.

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