Free Nursing Dissertations - Care Study Undergraduate Degree Level Essay 3,250 Words Introduction In This
Care Study
Undergraduate Degree Level Essay
3,250 words
Introduction
In this essay we are considering the case of Mr.B. Although we are specifically focusing on his care during the first 72 hrs. post op, we need to consider our overall knowledge of his history and lifestyle prior to admission if we are to try to give the best holistic care package that we can.
In the context of this essay it is accepted that we could use any one of a number of different nursing models for analysis. The Roy adaptation model (Roy C 1991) might be appropriate but it does not specifically consider the holistic aspects of care. For that reason we will analyse this clinical situation using the Roper Logan Tierney model (Holland K et al 2003). In broad terms we shall therefore consider the planning, delivery and evaluation of individualised nursing care in the specific case of Mr.B. with broader comments relating to nursing care in general.
Mr.B. has had a hip replacement arthroplasty for severe osteoarthritis of his right hip. There are a number of factors that are relevant to this particular consideration. Osteoarthritis is rarely a unilateral condition. Although it may be more severe in one hip, unless it is secondary to a traumatic injury it is very likely that there will also be changes in the second hip. (Thomas KS et al 2002).
The significance of this is that his weight is likely to be a contributory factor to the osteoarthritis. It is therefore of great importance that, after the immediate post operative period, we should include weight loss measures in his overall care plan. This should have the effect of reducing the strain on his left hip and also (as excess weight is a positive risk factor for premature failure of a replacement arthroplasty) it should help prolong the effective life of the arthroplasty that he has just had. (Spurgeon D 2002)
It is equally important that weight loss should not be seen by the patient as an isolated goal in itself. Ideally it should be presented and understood as part of a lifestyle change that should include dietary modification and increased exercise to not only reduce his weight but to improve his cardiovascular status generally. (Fawcett J 2005)
We are told that Mr.B. was having to have an amount of time off work prior to his operation. We could assume that this was partly due to pain. It is also possible that it may have a contribution from his weight and this will therefore help in both eventualities
Before we consider the post op. management of Mr.B. we should present a brief overview of the pathophysiology of his osteoarthritis.
Osteoarthritis
Osteoarthritis is a common chronic musculo-skeletal condition which tends to be symptomatic in the second half of life. Symptomatic osteoarthritis, particularly of the hip and knee, is the commonest cause of musculo-skeletal disability in the elderly although it commonly starts on the second or third decade of life.
