Care Study Y2

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Nursing care study
M10/558712
Catherine Williams
27/06/2011
SHN/252
Word Count: 4,270

Introduction:
This assignment will mainly focus on the immediate post operative care following a patient having undergone a unilateral total knee replacement. The aim of this assignment is to enable me as a student nurse to develop the knowledge needed to understand the role the nurse undertakes in providing holistic care for a patient. I will look at the nurse’s role in the postoperative care of a patient having undergone a unilateral total knee replacement, a patient whom I have cared for. I will discuss how the patient’s needs were assessed by the nursing team, and I will identify the main problems the patient will face. The use of Roper, Logan and Tierney’s Activities of Living (2001) will be used as the nursing model in this essay, it is appropriate for use as this model was the one used by the nurses in the hospital to ensure holistic care of the patients. This nursing model has been adapted by the recovery nursing staff, for use in the initial recovery phase of this patient’s stay in hospital. The nursing assessments used will first be discussed, and a problem that the patient faced will be identified. The care that the nurses provided for the patient regarding this problem will then be analysed using relevant up-to-date literature. Roper, Logan and Tierney’s (2000) 12 activities of daily living model will be used to assess the patient. Nursing models are important because they offer a framework to help guide nurses through the stages of the problem solving approach. Nursing models help those who use them to understand fully what they are doing and why they are doing it (Aggleton and Chalmers, 2000) The nursing process framework plays an important part in patient assessment and care. This is the process of assessing, planning, implementing and evaluating (APIE) and was introduced into nursing by Yura and Walsh (1967). They called it the nursing process because it attempted to direct nursing practice away from ritual practice and institution, with the aim that nurses would start to use a more structured systematic approach. The difference between models and frameworks is often difficult to define and sometimes the terms are even used interchangeably (McKenna, 1997). Roper et al use the word ‘assessing’ as opposed to ‘assessment’ because they suggest assessment is an ongoing active process (Roper, Logan and Tierney, 2000). Using this model, I will discuss the assessment process, the main priorities of care and discuss how one problem was identified and addressed by the nursing team. The topic that will be explored is Wendy’s nausea and vomiting after surgery. This care will be discussed with reference to relevant literature. The patient on whom this essay will be based is Wendy, a 76 year old lady who had a total left knee replacement due to osteoarthritis in the knee, and pain and difficulty mobilising associated with this (Lucas, 2004; Temple, 2006). Before undertaking the study consent was sought and gained from the patient before her pre operative assessment commenced and prior to the essay being started. This has been confirmed by the author’s mentor in the placement (see appendix 1). It was explained to Wendy what the study would involve and how all names and locations would be changed. This was to ensure anonymity; all names and locations in this essay have been changed in accordance with the Nursing and Midwifery Council Code of Professional Conduct (2008) in order to maintain confidentiality.

Nursing assessment:
Peri-operative care is an imperative part of patient care. The role of the nurse prior to Wendy’s surgery was to ensure that the she fully understood the nature of anaesthetic , surgery and possible complications. The nurse was there to ensure Wendy understood how she needed to be in optimum physical condition prior to surgery. Research has shown that preoperative patient education not only meets...
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