Acute Care Nursing: Osteoarthritis – Case Study Example

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The paper "Acute Care Nursing: Osteoarthritis" is a wonderful example of a case study on health sciences and medicine. Age: 63 years old Sex: Female Civil status: Divorced No. of children: 1 Profession: Retired school teacher Postoperative Complication Mrs Simone Cordalis had a history of osteoarthritis. However, Simone had tried many treatments for her osteoarthritis; including glucosamine, fish oil, acupuncture, and cortisone injections. She was subjected to total knee replacement surgery to correct this problem simply because the arthritic changes in her knees had made it increasingly difficult to perform her tasks as a physical education teacher. She also had to stop playing competitive tennis because of her pain worsening over the past three years.

However, possible problems can arise from surgery such as infection, pain or swelling. According to National Institute of Health (2002), Postoperative complications are the problems patients suffer from after undergo intrusive means of treatment (surgery) of these conditions some of these complications are: Infections, Thrombosis, Nerve injury, Morbidity of muscle, Inflammation and Pain. Infections: According to a study done by Maetzel et al (2004) and National Institute of Health (2002), some of the patients suffer from infection from either Staphylococcus aureus or even Clostridium tetani at the site of operation (wound), after undergoing such processes.

The common infection presented to surgeons is infections of soft tissues such as abscesses and Joint infections. Mrs Simone Cordalis would most likely experience the nosocomial infection at the site of operation. The risk factor for such infection is due to the presence of environmental pathogens and further aggravated when there is an inadequate aseptic technique performed during operation. Gram-positive bacterium; Staphylococcus aureus is among the common pathogen which causes wound infections while Gram-negative bacterium; Pseudomonas aeruginosa has been cited in numerous studies as the main causal of nosocomial infection since it is an environmental pathogen.

Furthermore, P. aeruginosa can result to delay in wound healing in most cases (Carter & Cole, 1990). Thrombosis: This is the formation of a thrombus (clot) in blood. This complication has been found to occur in patients after operation despite the use of prophylactic anticoagulant, or anti-embolic stockings. Mrs Simone Cordalis would most likely experience this complication following a knee operation. The occurrence of these blood clots and emboli in a patient impairs blood flow and may even cause vascular disorders.

Acute ischaemia of limbs, brain or intestine can result due to arterial embolism. The extensive complication can be realized when the blood supply is restored by embolectomy after ischaemia, however, further damage can arise due to reperfusion syndrome (Zhao, 1999; National Institute of Health, 2002). According to AHRQ (2009), the majority of chronic leg ulcers arises since chronic venous insufficiency in the lower limb since leads to venous hypertension, which is a risk factor for such complication. Nerve injury: nerve injury to the knee can also be experienced by some patients caused by pressure subjected to the nerve and sensory and motor areas of that nerve territory, by either tourniquet or any other physical damage that might have occurred during the process (National Institute of Health, 2002, 2008).

Following knee surgical procedure, Mrs Simone Cordalis would most likely experience this complication. This may lead to loss of function of the leg afterwards (National Institute of Health, 2002, 2008).

References

Arthritis and Musculoskeletal Alliance, ARMA (2004) Standards of Care for People with Osteoarthritis: London; ARMA

Arthritis Foundation (2008) Arthritis Ambassador Kit, Section Three: Tools & Resources pp.1-2

Agency for Healthcare Research and Quality, AHRQ, (April 2009). Osteoarthritis of the Knee / A Guide for Adults: AHRQ Pub. No.09-EHC001-A. pp 1-4

Carter, G.R and Cole, J.R. (1990) Diagnostic Procedures in vet Bacteriology and Mycology, 5th` Edn, Academic Press, Inc, London, and Newyork.

Chamberlain MA, Care G (1982) Physiotherapy in Osteoarthritis of the knees: A controlled trial of hospital versus home exercises. International Rehabilitation Medicine 4 (2): 101–6.

Maetzel A, Li LC, Tomlinson F, Bombardier C, Pencharz J. (2004). The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: A comparative study. Ann Rheum Dis; 63(4):395-401

National Institute of Health (July 2002). Osteoarthritis: National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH Publication No. 02-4617. pp.5-40

National Institute of Health (February 2008). Osteoarthritis: The care and Management of adult osteoarthritis in adults, NIC clinical guideline 59; pp.10-25

Yen ZS, Lai MS, Wang CT, et al., (2004) Cost-effectiveness of treatment strategies for osteoarthritis of the knee in Taiwan: Journal of Rheumatology 31: 1797–803

Zhao SZ, McMillen JI, Markenson JA et al. (1999). Evaluation of the functional status of health-related quality of life of patients with osteoarthritis treated with celecoxib. Pharmacotherapy 19 (11): 1269-78.

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