Critical Thinking Exercise
Nursing Management of the Client with Total Hip Replacement
Situation: A 72-year-old male client is being discharged home from the hospital following hip replacement surgery. In addition to the prevention of other complications, the staff has made every effort to prevent deep vein thrombosis and pulmonary embolism: the two most common causes of postoperative mortality in older clients. Prior to discharge, the nurse gives the client a list of instructions for positioning, sitting, and ambulating at home. The client is also instructed to use a walker or crutches until weight bearing is safe, and to employ adaptive devices for everyday activities. Finally, the client is advised to watch for any signs of hip prosthesis loosening or dislocation, and to call the surgeon immediately if such signs occur. 1. What are the signs and symptoms of deep vein thrombosis and pulmonary embolism?
Deep Vein Thrombosis
* Swelling of the leg or along a vein in the leg
* Pain or tenderness in the leg, which you may feel only when standing or walking * Increased warmth in the area of the leg that's swollen or painful * Red or discolored skin on the leg
* Unexplained sudden onset of shortness of breath
* Chest pain or discomfort that worsens when you take a deep breath or when you cough * Feeling lightheaded or dizzy, or fainting
* Rapid pulse
* Coughing up blood
* A sense of anxiety or nervousness
2. What types of adaptive equipment is available for clients who have undergone hip replacement surgery?
Adaptive equipment to help in daily activities:
* Reaching – use a reacher in getting items from cabinets or off the floor. Do not bend over to pick up something from the floor.
* Dressing - since you are not to bend past 90 degrees, use adaptive devices to be as independent as you can when dressing.
-Wear slip-on shoes or use elastic...