Get the latest public health information from CDC: The description and review of nursing interventions being provided in a hospital are necessary to delineate nursing work and improve nursing practice. In cases where a severely damaged hip is present, an artificial joint is used to replace the non-functional area. Questions/request for information, statement of misconception, Inaccurate follow-through of instructions, development of preventable complications. Rationale: Provides information on which to base and monitor effectiveness of interventions. I am in my 1st semester of nursing and on my 1st week of clinicals I had a post-op pt with an elective total hip replacement the prior day.

Participate in ADLs/rehabilitation program. Total Hip Replacement surgery is indicated in the following conditions: Arthritis such as rheumatoid arthritis and degenerative joint diseases; Fractures of the femoral neck; Failure of previous reconstructive surgeries such as failed prostheses, osteotomy and femoral head replacement; Problems that results from congenital hip disease; Nursing Interventions

Investigate reports of increased incisional pain, changes in characteristics of pain. NLM

Keep linens dry and wrinkle-free. Inadequate primary defenses (broken skin, exposure of joint), Inadequate secondary defenses/immunosuppression (long-term corticosteroid use, cancer), Invasive procedures; surgical manipulation; implantation of foreign body. Here are five (5) nursing care plans (NCP) and nursing diagnosis for patients undergoing Total Joint Replacements: You may also like the following posts and care plans: Care plans related to the musculoskeletal system: is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. Discuss need for safe environment in home (removing scatter rugs and unnecessary furniture) and use of assistive devices (handrails in tub or toilet, raised toilet seat, cane for long walks).

Rationale: Position and length of peroneal nerve increase risk of direct injury or compression by tissue edema or hematoma. Review and have patient or caregiver demonstrate incisional/wound care. Rationale: Tachycardia and decreasing BP may reflect response to hypovolemia or blood loss or suggest anaphylaxis related to absorption of methyl methacrylate into systemic circulation. Administer narcotics, analgesics, and muscle relaxants as needed.

Deep infection may require removal of the implant. A semi-reclining wheelchair and toilet seat extenders may be used to minimize hip joint flexion. One of the most successful surgeries in orthopedics is the total hip replacement. The recent xray shows the patient as a Intra-Trochanteric fracture of the hip. Epub 2011 Feb 23. Maintain intermittent compression stocking or foot pumps when used. Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, 5 Total Joint (Knee, Hip) Replacement Nursing Care Plans. Here are 13 nursing diagnosis for a client undergoing surgery or perioperative nursing care plans (NCP): Deficient Knowledge (Pre-op) Fear/Anxiety; Risk for Injury; Risk for Injury (Pre-op) Palpate pulses on both sides. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics.

Muscle aching indicates too much weight bearing or activity, signaling a need to cut back. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Results: Rationale: Meets specific needs of the replaced joint. Demonstrate and assist with transfer techniques and use of mobility aids, e.g., trapeze, walker. Rationale: May be done initially to reduce contact with sources of possible infection, especially in elderly, immunosuppressed, or diabetic patient. Mobilization with ion limits and in proper flexion is encourage. On the first day of admission, the 5 most frequent nursing interventions were intravascular administration, care plan, orthotics management, teaching/emotional support, and elimination care.

Rationale: Prevents dislocation of hip prosthesis and prolonged skin or tissue pressure, reducing risk of tissue ischemia and/or breakdown.

Prevents contamination and risk of wound infection, which could require removal of the prosthesis. Br J Nurs. Note: Infection is devastating, because joint cannot be saved once infection sets in, and prosthetic loss will occur. Achieve timely wound healing, be free of purulent drainage or erythema, and be afebrile. Patient must be cautioned not to sit too low or cross the legs. Rationale: Reduces muscle tension; improves comfort, and facilitates participation. This site needs JavaScript to work properly.

Rationale: Reduces muscle tension, refocuses attention, promotes sense of control, and may enhance coping abilities in the management of discomfort or pain, which can persist for an extended period. Note swelling in operative area. Nursing care planning and goals for patients who underwent total joint replacement include preventing complications, promoting optional mobility, alleviate pain, and providing information about the diagnosis, prognosis, and treatment needs. (see section below on interventions when transferring or sitting the patient who underwent total hip replacement). Maintain affected joint in prescribed position and body in alignment when in bed. Nursing Diagnosis. Lovenox is a low-molecular weight heparin that requires no routine monitoring of coagulation times. Determine upper body strength as appropriate. Higuera CA, Elsharkawy K, Klika AK, Brocone M, Barsoum WK. Ensure that stabilizing devices (abduction pillow, splint device) are in correct position and are not exerting undue pressure on skin and underlying tissue. Instruct in home use of CPM exercise program. When drainage volumes are greater than expected, the nurse should notify the physician immediately. Remove indwelling urinary catheters and portable wound suction as soon as possible to prevent infection. Use strict aseptic or clean techniques as indicated to reinforce or change dressings and when handling drains. Long-term restrictions depend on individual situation or physician’s protocol. Rationale: Conserves energy for healing and prevents undue fatigue, which can increase risk of injury or falls. Rationale: Increasing pain, numbness or tingling, inability to perform expected movements (flex foot) suggest nerve injury, compromised circulation, or dislocation of prosthesis, requiring immediate intervention. Verbalize understanding of surgical procedure and prognosis. Instruct and monitor use of PCA and/or epidural administration.

Absence or limitation of preoperative preparation and teaching increases the need for postoperative support in addition to managing underlying medical conditions.


Nursing care plans should be focused on preventing the occurrence of the following complications: The new hip can be dislocated easily.

Rationale: Indicative of slippage of prosthesis, requiring medical evaluation and/or intervention. Heat may then be used to enhance circulation, facilitating resolution of tissue edema. Demonstrate use of relaxation skills and diversional activities as indicated by individual situation.

As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.

Finding help online is nearly impossible. Initiate and maintain extremity mobilization: ambulation, physical therapy, exercise and/or CPM device. Prepare for surgical procedure as indicated. Rationale: Deep, dull, aching pain in operative area may indicate developing infection in joint. Investigate sudden increase in pain and shortening of limb, as well as changes in skin color, temperature, and sensation.

Thus, the nurse must promote patient teaching on preventing hip prosthesis dislocation which includes the following: When transferring or sitting the patient who underwent total hip replacement: After THR, a thrombus, also known as blood clot, may form in the veins of the client’s thighs, pelvis or leg. Rationale: Bacterial infections require prompt treatment to prevent progression to osteomyelitis in the operative area and prosthesis failure, which could occur at any time, even years later. Patient Positioning: Complete Guide for Nurses, Registered Nurse Career Guide: How to Become a Registered Nurse (RN), NCLEX Questions Nursing Test Bank and Review, Nursing Care Plans (NCP): Ultimate Guide and Database, Nursing Diagnosis Guide: All You Need to Know to Master Diagnosing. Protect operative heel, elevating whole length of leg with pillow and placing heel on water glove if burning sensation reported. As prophylaxis for DVT following total hip replacement surgery, low-dose heparin or enoxaparin (Lovenax) may be used. Involve in exercise program.

Find NCBI SARS-CoV-2 literature, sequence, and clinical content: Injuring agents: biological, physical/psychological (e.g., muscle spasms, surgical procedure, preexisting chronic joint diseases, elderly age, anxiety), Reports of pain; distraction/guarding behaviors, Alteration in muscle tone; autonomic responses.

Massage skin and bony prominences routinely.

Risk for Peripheral Neurovascular Dysfunction, Nursing Care Plan: The Ultimate Guide and Database, Arterial Blood Gas Interpretation for NCLEX (40 Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. To decrease the homologus blood transfusions, autotransfusion drainage system may be used. Observe appropriate limitations based on specific joint; avoid marked flexion and/or rotation of hip and flexion or hyperextension of leg; adhere to weight-bearing restrictions; wear knee immobilizer as indicated.

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