NORTHWEST HOSPITAL MEDICAL CENTER
PREP #1 ORTHOPEDIC POPULATION
1.
2.
3.
4.
Provide definition and pathophysiology of Osteoarthritis.
Discuss the risk factors for Osteoarthritis.
Discuss the typical signs & symptoms of Osteoarthritis.
Describe the medical management (pharmacologic & non-pharmacologic)
for Osteoarthritis.
5. Provide a description the following surgical interventions for
Osteoarthritis:
a. Total Knee Arthroplasty (TKA)
b. Total Shoulder Arthroplasty
c. Total Hip Arthroplasty (THA) (anterior and posterior approach)
(sources for 1-5 should be from a medical surgical textbook, reliable
internet sources that provide medical information written for health care
personnel (not written for general public).
6. Discuss the pre-op care and education for total joint replacement
including:
a. Pre-op preparation for surgery
b. Pre-op lab work and diagnostic tests – discuss the reason for these
being done.
c. Patient education on surgery and post-op care.
d. Include any differences (if any) in the pre-op care and education
for the specific joint replacements.
7. Discuss the Post-op care and education for total joint replacement
including:
a. Post-op nursing care (beginning post-op through discharge).
b. Post-op labwork & diagnostic testing
i. Discuss purpose for monitoring these labs/tests.
c. Post-op patient education and discharge teaching.
d. Activity precautions/limitations for each type of joint
replacement.
e. Include any differences in the post-op care, precautions and
education for the specific joint replacements.
(sources for 6-7 should be from a medical surgical textbook, a lab and
diagnostic reference book or from the NWH clinical packet PDF on fac web
site including the helpful hints on ortho patients, the TKR surgery article,
the bone and joint center handout, and the physical therapy handout).
8. Compartment syndrome is a serious post-operative complication of
orthopedic surgery. Describe this complication and what causes it.
Provide the signs and symptoms to monitor for. Discuss the treatment of
compartment syndrome.
9. Discuss other potential post-operative complications for total joint
surgical procedures. What should be included in the nursing care plan to
address each of these potential complications?
03/06/2011 NEW
(sources for 8-9 should be from a medical surgical textbook)
10. Patients are typically on either PCA or PCEA (epidural) pain
management post-operatively. Discuss the assessments and monitoring
that the nurse should include in the plan of care when a patient is
receiving each of these pain management systems.
(sources for 10 should be from the handout on the NWH policy and
procedure for PCA and epidural).
11. TKR patients at NWH may receive Duramorph injections during the
surgical procedure. Discuss how Duramorph works and the nursing
considerations for patients who have received this medication.
(sources for 11 should be from the handout on Duramorph in the NWH
clinical packet PDF on the fac web site)
12. Write out a medication page (in syllabus) for the following medications:
(include classification of med, how medication works, purpose for this
patient population, nursing considerations including side effects &
contraindications, labs to monitor)
a. Coumadin 5mg po this evening
b. Docusate Sodium 250mg po BID
c. Cefazolin Sodium 1gm Q8H IVPB
d. Hydromorphone PCA 0.2mg/ml: 1ml/10minutes/8ml hour limit.
e. Zofran 4mg IV push Q8H PRN Nausea
f. Reglan 10mg IV push Q6H PRN Nausea
g. Milk of Magnesia 30ml PO QD PRN constipation
h. D5 1/2NS w/ 20meq KCL @ 100ml/hr
i. Epidural infusion: Bupivicaine 1/16% and Fentanyl 2mcgs/ml @
5 continuous and PCEA: 5ml/20min/25ml hour limit.
(sources for 12 should be from a nursing drug guide or Micromedex).
Include a reference page with all sources used in researching prep work.
Also cite references throughout text.
03/06/2011 NEW
03/06/2011 NEW