Nursing Care of the Elderly Patient with Osteoarthritis after Total Knee Arthroplasty Surgery: Case Study

Abstract

Osteoarthritis is a common health problem among the elderly. Total knee arthroplasty surgery is the most effective treatment for severe osteoarthritis of the knee. Nurses play an important role in caring for patients with osteoarthritis. Both before surgery, after surgery, and before discharge home.

Objective: To study the nursing care for the elderly patient with osteoarthritis after total knee arthroplasty surgery

Methodology: This is a case study of a 61-year-old Thai female patient who presents with severe left knee pain and difficulty walking for 1 month. The patient stayed 4 days, from October 30 to November 3, 2022, in the female orthopedic unit at Chaiyaphum Hospital. Data has been collected from patient and family interviews, physical examinations, observations, and medical records.

Result: A case study was an elderly patient with severe osteoarthritis receiving treatment for left total knee arthroplasty surgery. Before the surgery, it was found that the patient had high blood pressure. The patient was evaluated using 11 Gordon's functional health patterns, and NANDA nursing diagnoses were used for nursing diagnosis as follows: 1) the patient lacked knowledge about the disease and operation procedure 2) risk of accidental falls 3) any complication that may occur from anesthetic drugs 4) risk from blood loss 5) patient discomfort from tissue injury 6) risk of knee infection 7) opportunity of deep vein thrombosis and 8) lack of knowledge and understanding of preparing before returning home. Patients returned for follow-up appointments two weeks, one month, and three months after being released from the hospital. In the left knee, the patient made a full recovery. Patients could move around by utilizing a walker. EQ5D5L was used to evaluate the quality of life following both knee arthroplasties. It was shown that 82.9% of them were healthy compared to before surgery, and the knee's range of motion was greater. The patient can perform daily tasks and lead a normal life following the implantation of both knee joints.

Conclusion: After nursing care for this patient according to Gordon and NANDA's theory, there were significant postoperative risks, including knee stiffness and infection. Therefore, the important advice is to exercise the knee and observe abnormal symptoms of infection such as pain, swelling, redness, and heat to ensure patient safety and good recovery after surgery.