Question

Write Nursing process for Postoperative Care of the Patient.

-Select an example of orthopedic surgery (virtual)
-Follow the steps of nursing process (assessment, diagnosis, planning, intervention, and evaluation)
-Design nursing care plan as framework.

Answer 1

Nursing Process: Post-Operative Care Of the Patient Undergoing Orthopaedic Surgery:

Assessment:

The nurse continues the postoperative care plan even after the orthopaedic surgery. The nurse reassesses the needs of the patient in relation to pain, neurovascular status, health promotion, self-esteem, and mobility. Tissue perfusion should be closely monitored because bleeding and edema into the tissues can compromise circulation as a result of compartment syndrome.

The nurse note down the prescribed limits on mobility and assesses the patient’s understanding of the mobility restrictions. The nurse also assesses and monitors the patient potential problems related to the surgery. Further, the nurse reports abnormal findings to the physician.

In major orthopaedic surgery, there is a high risk of hypovolemic shock because of blood loss. The nurse must be alert for the signs of hypovolemic shock. Elevation in temperature within 48 hours is frequently related to atelectasis or respiratory problems. Superficial wound infections take 4-6 days to develop for phlebitis usually occurs during the end of the first week. The nurse closely monitors all these aspects. Thromboembolic disease is most common in postoperative orthopedic surgery. The nurse should assess the patient daily for tenderness, swelling, redness of the calf. Further, the nurse must be alert to the change in respiration behavior as fat embolus may occur with post orthopedic surgery.

Diagnosis:

The diagnosis for post orthopedic surgery is done based on the assessment data by the nurse, which includes:

-Pain-related to surgical process, swelling, and immobilization.

-Risk for peripheral neurovascular dysfunction.

-Risk for ineffective therapeutic regimen management.

-Risk of situational low esteem.

-Impaired physical mobility related to pain and edema.

Planning:

The nurse works on the plan after the orthopaedic surgery for the patient to provide:

- Relief of pain.

-adequate neurovascular function.

- Health promotion

- Improved mobility

- Absence of complications

-Positive self-esteem

Intervention:

Relief of pain: Post orthopaedic surgery is followed by intensive pain. The nurse should closely monitor the pain level of the patient and make efforts to relieve the discomfort and pain.

Adequate neurovascular function: The nurse monitors the neurovascular status of the involved body part and informs the physician if any indications of diminished tissue perfusion are there. The patient is reminded and guided to perform the exercises hourly.

Health promotion: The nurse encourages the patient to participate in the postoperative treatment regime, maintain a well-balanced diet with adequate protein and vitamins in order to heal the wound.

Improve mobility: Post-surgery education and physical activity assistance should be provided by the nurse as the patient becomes reluctant to move after orthopedic surgery.

Positive self-esteem: Increase in the self-care activity is set by the nurse within the limits to promote self-esteem and performance.

Evaluation:

The expected outcomes of the patient include the following:

- Decrease in the level of pain.

-Promotes healthy habits.

-Exhibits adequate neurovascular function.

-Express positive esteem.

-Maximise in the mobility within the therapeutic limits.

- Absence of complications.

Nursing care plan

Nurses have a vast role associated with the patient’s surgical management: The nursing care plan includes the following:

-Risk for trauma

-Acute pain

-Risk for peripheral neurovascular dysfunction

-Risk for impaired gas exchange

-Impaired physical mobility

-Impaired skin integrity

-Risk for infection

-Deficient knowledge

-Risk for injury

-Self-care deficit

-Constipation