Thursday, January 20, 2011

Nursing Diagnosis and Nursing Intervention for Osteoarthritis

Nursing Care Plan for Osteoarthritis


Nursing Diagnosis (Postoperative)
  • Acute pain, related to surgical incision
  • Risk for infection, related to disruption in skin integrity
  • Impaired physical mobility, related to activity and weightbearing
    restrictions
  • Risk for ineffective tissue perfusion, right leg, related to vascular
    disruption and edema.

Exepected Outcomes
  • Maintain an adequate level of comfort postoperatively as demonstrated by :
    • The ability to move easily within restrictions.
    • Compliance with instructions to cough and breathe deeply.
    • Verbal expressions of comfort.
  • Remain free of adverse consequences of immobility such as pneumonia, pressure areas, thromboembolism, or contracture.
  • Remain free of infection.
  • Maintain adequate perfusion of affected leg.
  • Remain free of injury postoperatively.

Nursing Intervention
  • Assess pain at least hourly during first 24 to 48 hours postoperatively, and as needed thereafter.
  • Instruct in the use of patient-controlled analgesia (PCA) and monitor its effectiveness.
  • Help change position at least every 2 hours; encourage the use of the overhead trapeze to shift positions frequently.
  • Maintain sequential compression device and antiembolic stocking as ordered; remove for 1 hour daily.
  • Encourage the use of the incentive spirometer hourly for first 24 hours, then at least every 2 hours while awake.
  • Assist out of bed three times a day after the first 24 hours.
  • Maintain abduction of the right hip with pillows.
  • Perform passive ROM exercises of unaffected extremities every shift.
  • Encourage frequent quadriceps-setting exercises and plantar and dorsiflexion of feet.
  • Assess the surgical site frequently; report signs of excess bleeding or inflammation.
  • Monitor temperature every 4 hours.
  • Assess pulses, color, movement, and sensation of right foot hourly for the first 24 hours, then every 2 hours for 24 hours, then every 4 hours.


Source : wps.prenhall.com/wps/media/objects/737/755395/osteoarthritis.pdf

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