The Nursing Care for Total Knee Arthroplasty: A Study of Two cases
Abstract
Abstract
Background: Knee osteoarthritis occurs most frequently in elderly. Knee pain and knee stiffness has interfered patient’s daily life. Their quality of life and their family’s quality of life have been affected. Total Knee Arthroplasty is the most effective treatment method for the severe knee osteoarthritis. The nurse plays an important role in assessing patient's health conditions and providing holistic nursing care with the aim of preventing complications, promoting the patient to continue their normal activities and improving their quality of life.
Objective: To study the nursing care for two patients with Knee osteoarthritis post-operative Total Knee Arthroplasty
Methods: A comparative study of 2 osteoarthritis patients who received total knee replacement surgery was admitted to Takuapa Hospital. Data collections were used by interviewing, observations, and medical records. Then, the nursing process was performed in terms of Gordon's health assessment, nursing diagnoses along with guidelines of the American Association of Nursing Diagnostic, nursing implementation, and evaluation.
Results: The results revealed that both osteoarthritis patients had the same nursing problems before the operation. The problems were knee pain and movement limitation due to osteoarthritis. Total Knee Arthroplasty was required for both patients because of those problems. Both patients had different nursing problems and severe complications at post-operation. The first patient had anemia due to blood loss during early 3 hours after the operation, while hypokalemia and severe anxiety have happened in the second patient at 24 hours post-operation. There was still severe anxiety in the second patient at 72 hours post-operation, and pain at the surgical wound was occurred. Those issues were a barrier of rehabilitation, and the infected wound was found on day 8th after the operation.
Conclusions: Competency in nursing practice is essentially required for nurses who care for patients with Total Knee Arthroplasty. The nursing care should be started at the preoperational period, such as physical and mental preparation, providing advice on conducting pre and post-operation. Pain management, complication monitoring, rehabilitation by promoting exercise of leg muscles and knee are required after operation for patient safety without complications and well rehabilitation.
Keywords: nursing care, Osteoarthritis of Knee, Total Knee Arthroplasty
