Total Knee Replacement Essay

Total Knee Replacement Essay
Introduction: A total knee replacement is a proven cost–effective treatment for end–stage
osteoarthritis, with a positive effect on pain and function. However, only 80% of the patients are
satisfied after surgery. The main reason to proceed with a TKA are pain and problems with activities
of daily living (ADL). It is known that high preoperative expectations and residual postoperative
pain are important determinants of satisfaction, but also malalignment, poor function and disturbed
kinematics can be a cause.
Objectives: The purpose of this study was to investigate the correlation between the preoperative
function and the postoperative patient reported outcomes (PROMs) as well as the influence of the
postoperative functional rehabilitation on the PROMs. ... Show more content on Helpwriting.net ...
With a significant difference for the active and passive ROM toward knee flexion
(p=0.007;p=0.008), asymmetry in active and passive ROM toward flexion between the healthy leg
and the leg with the TKA (p=0.001;p=0.001), Quadriceps– and Hamstrings strength
(p=0.001;p<0.001), all parameters for the 6MWT and the time of the SCT (p=0.001). Regarding the
prediction model, the 6month PROMs can be predicted by some parameters for the 6MWT (distance
(p=0.001), gait steps (p=0.002) and step time TKA (p=0.007)). These parameters are predictors for
the score on the subscales 'symptoms' and 'pain' of the KOOS questionnaire. 1 Year after surgery,
there is an improvement of all parameters, except for the active and passive ROM toward knee
extension. However, these differences are not significant. The 1 year PROMs can only be predicted
by the muscle strength (Quadriceps– and Hamstrings strength (p=0.026; p=0.039) and the
asymmetry in Quadriceps strength between the healthy leg and the leg with the TKA (p=0.031)).
The score on the subscale 'pain' can be predicted based on the parameters mentioned
... Get more on HelpWriting.net ...

Total Knee Replacement Research Paper
In Japan, there is approximately 70,000 knee replacement surgeries completed a year. Total knee
replacement (TKR), also known as total knee arthroplasty (TKA), is a common surgery performed
on patients with severe osteoarthritis of the knee. Anshin Hospital in Japan made every patient sign
a consent form prior to starting the research study. Total knee replacement surgery will enhance
patient's quality of life, pain relief and functional recovery over time with the use of rehabilitating
gait training. This prospective cohort research study performed early treatments for 57 patients that
had osteoarthritis. Joint range of motion and strengthening quadriceps muscles are significant for the
best outcome of total knee replacement. In order to have the best outcomes after total knee
replacement, early rehabilitation is pivotal. ... Show more content on Helpwriting.net ...
The goal in this study were for patients to make a speedy recovery with the help of early gait
training, and to return to their daily activities after hospital discharge without the risk of falling.
Osteoarthritis patients have a high risk of falling, this study rehabilitated patients who were at risk
for falling upon hospital discharge after knee surgery. Primary unilateral total knee replacement was
performed for patients suffering from osteoarthritis. The population consisted of a convenience
sample, also known as a non–probability sample. These patients were easy to target in the hospital,
they were suitable for the study in regards to osteoarthritis and needing total knee replacement. This
study proved that gait variability did not change that much with preoperative rehabilitation and
postoperative rehabilitation. The patient's stability was similar before and after the

Essay Paper on Total Knee Replacement Surgery
People undergo total knee replacement when arthritis or injury erodes the joint's natural cushioning
to the point where it's hard to walk even short distances without severe pain.
Knee replacements now cost the NHS more each year than total hip replacements. An ageing
population and an increase in obesity–related conditions are placing an increasing strain on NHS
resources, with the number of knee replacements performed rising by 15 per cent last year from
59,391 to 68,300. Doctors predict that by 2010, suchoperations could cost the NHS almost pounds 1
billion per year.
The average age for a total knee replacement is 70. Osteoarthritis, one of the four most common
problems linked to obesity, is the major ... Show more content on Helpwriting.net ...
There are actually three reasons the doctor (an orthopedic surgeon) will recommend an artificial
knee. These are: 1) to relieve pain 2) to restore function and 3) to achieve stability. As the arthritic
knee becomes more painful, the patient will use it less. Function, therefore, is lost. As the arthritic
knee continues to deform, the patient will feel that the joint is wobbly or unstable.
The most common indication for total knee replacement is osteoarthritis, or degenerative joint
disease. The end stage of osteoarthritis is wearing out of cartilage (smooth, gliding bone ends)
resulting in bone–to–bone contact in diseased joints. It is progressive and becomes increasingly
painful as the cartilage erodes. Younger people who get knee replacements have damaged their
joints by trauma (accidents that destroy joint surfaces), infection, cancer or tumor, and inflammatory
conditions such as rheumatoid arthritis.
Painful knees are the most common manifestation of osteoarthritis, while osteoarthritis in turn is the
most common of the different kinds of arthritis. About 60 percent or more of arthritis sufferers have
this form. But this is not the most difficult. Rheumatoid arthritis is often deforming and most painful
of the hundred or so forms of arthritis.
Osteoarthritis can found in all weight–bearing joints such as the spinal column, the hips, the ankles,
and the knees. Osteoarthritis in the knees is

Statement Of Purpose Of Robots
Statement of Purpose
Robots are going to be new citizens in the human society. Day by day it proved its capabilities and
capacity, starting from very sophisticated Medical Surgeries to versatile and simple pick and place
application. New and innovative concepts like Origami Robots, Spatial Manipulators, Biological
Robots and many such have justified their importance. The core aspect of all such robots and
families is their peculiar Kinematics and Dynamics. So, at the heart of all such innovation, it
requires fundamental excellence and knowledge in this field. Stanford University stands for legacy
in Innovation and Robotics. It is always a preference to work in kinematics in this university.
Various labs like Biomimetics and Dextrous Manipulation Laboratory and Stanford Robotics
Laboratory Inspires me a lot. ... Show more content on Helpwriting.net ...
During master of technology at IIT–Bombay l took courses like kinematics and dynamics of
machines, which was an extension of an undergraduate course, a course of Computer Simulation of
Machines was an excellent exercise on developing our own code to simulate the mechanisms and a
course of advanced engineering Dynamics had provided an insight into Non–Linear systems. I took
a Seminar on Kinematics and Dynamics of Tensegrity Mechanism. During all these academic
exercises, I developed the sense of Kinematics and Dynamics. It was the parallel practice of Physics,
Mathematics, Imagination, and Art. Based on this only, in my master's thesis work a new spatial
parallelogram mechanism was invented and undergone intellectual property rights. At Stanford,
courses like Advance Kinematics(Me330) and Kinematic Synthesis of Mechanisms (Me 331) will
be compelling with my

Essay about Nur 443 Literature Research Worksheet
University of Phoenix NUR 443 Evidence–Based Nursing Research and Practice June 18, 2012
Jacquelyn Zirbes University of Phoenix Material Literature Search Worksheet * Select a literature
search topic relevant to your practice. The topic must be sufficiently delineated in scope without
being trivial. You will revisit this article in the Week Five presentation. Possible topics include but
are not limited to: * * Non–pharmacological pain relief with childbirth * Effects of shift work and
fatigue on medication errors * Best practices for pin site care * Nurse satisfaction in magnet
hospitals * Accurate temperature assessment methods in neonates * Pain assessment in the
cognitively impaired * ... Show more content on Helpwriting.net ...
* * Leach, D., & Bonfe, M. (2009). The effectiveness of Femoral/Sciatic nerve blocks on
postoperative pain management in total knee arthroplasty. Orthopaedic Nursing, 28(5), 257–62.
http://search.proquest.com/docview/195964994?accountid=35812 * | * Answer the following
questions using your selected research article: * 1. Is this qualitative or quantitative? What is the
study design? What criteria did you use to determine the study design? * * My article is a
quantitative research. The researchers used an experimental research design which includes a total
of 130 patients who had total knee replacements. The controlled group of 65 patients received
general or spinal anesthesia with conventional narcotic management postoperatively, while the
intervention group of 65 patients received general or spinal anesthesia with femoral/sciatic nerve
block post–operatively. * The criteria I used to determine the study design is looking at what kind of
study the research is. In descriptive and correlational studies, there are no treatments involved
(Burns & Grove, 2011). Since this study has treatments involve and the researchers have
control over the treatments, it is experimental. Experimental study also uses a smaller sample size
like the sample size in the article. It also involves 3 characteristics namely: (1)

Personal Note On The Worst Nightmare Of My Life
I had never been so tense and angry in my life. I spend the last seven months with an infinite to–do
list, yet my worst nightmare was about to begin. When I look back to these memories, this
experience left a bad taste in my mouth. I realize that I would not have completed it without the
assistance and support of my family. The story began on December 15, my birthday, when I first met
my dear husband Mostafa. I started dreaming about a perfect, loving, and cheerful life. Soon after
that, we got to know each other and started to plan for our life and our journey to the United States.
Ten days later, my life took a tragic turn. My mother was at the hospital for almost two weeks. She
had a knee replacement surgery, which is a painful and agonizing operation. I felt terrible; it was as
if someone took a piece of my heart. However, this incident left me high and dry. My mother was no
longer around to help me because at that time I really needed her by my side. Nevertheless, I told
myself, "I need to control these emotions and be strong for her." When you do not think that things
could get worse, it really does. My mom's wound got infected and she had to go under the knife
again to sterilize the wound and stitch it, but this time she was only hospitalize for two days.
Subsequently, she left the hospital and I started my duty as a full time nurse to my beloved mother.
While taking care of my mother, things become out of control when my brother decided that I would
also be

Advantages And Disadvantages Of Knee Replacements
Introduction Latest advancement in polymer science enhanced the manufacturing of innovated
medical products. These products are considered as lifesaving that is associated with the modern
techniques of building human parts. Scientists are working on making spares for human parts for
various reasons. Some operation of transferring animal orgasms into human were failed, others
produce negative effects for human. Yong indicates that pigs have the ability of providing human
parts such lungs or livers and it will work appropriately into human hosts2. Nevertheless, many
operations of transporting kidneys or hearts were failed. Some scientists faced many problems in
transferring the living parts from an animal to human; as many of the transplanting operations were
failed, they decided to build or engineer human parts from ... Show more content on Helpwriting.net
...
Nowadays the current generation demands total knee replacements that would suite their lifestyles,
where it was done only on old people with severe medical conditions in the past. The need for
making these knee replacements was evolved and pushed to fit the youth generations as well. As
polymers are being concerned, knee replacements like titanium or cobalt chromium are used to
replace the regular knee, but it comes with a risk. According to Greengard, if patients did not notify
surgeons with metal allergy before the operations, it can lead to troublesome complications after the
surgery. Greengard also claims that failure in this operation can lead to infection in the knee
location, pain, stiffness, wearing, instability and other risks that can come from different associated
health factors14. It can be deduced that the percentage of risk low. Nevertheless, total knee
replacement could be a solution for patients who are in a critical condition. The only problem that
remains is the lifespan of the polymer in the joint, which can cause health hazards in the long

Knee Replacement: A Case Study
Introduction
The primary apprehension pertaining to the total knee replacement (TKR) is that the tibia tray
suffers from aseptic loosening and it occurs due to physical stress shielding pertaining to the bone
which further may need a revision surgery. The finest material is expected to be put to use for the
process pertaining to the TKR surgery (Nasab & Hassan, 2010). According to Okazaki et al. (2004)
the material used for prosthesis which had rigidity had lead to stress pertaining to the components
along with the bones that are adjacent to the artificial knee. It leads to affecting the bone stress
shielding as well. During the recent times, there has been development of such graded materials
which have been invented for being considered as the probable tibia try biomaterial pertaining to the
implant for ensuring enhancement in the ability pertaining to the distribution of the stress
experienced.
Bahraminasab and Jahan (2015), highlighted the strategy that can be chosen for selecting the
requisite material for acting as the tibia tray during the knee implants based on the multi–criteria
decision making approach in order to increase both its durability and the quality. Porous NiTi
(SMA) due to possessing superior properties than the rest of the materials was chosen for the
purpose of knee implant. The paper highlights ... Show more content on Helpwriting.net ...
It possesses finer characteristics required from the material to become appropriate for implant
purposes. The calculations discussed below were employed via VIKOR technique for determination
of the different characteristics as well as performance of the candidate

Total Knee Replacement
Managing Mobility After a Total Knee Replacement
November 15, 2011
INTRODUCTION In Kindred Rehabilitation, the patient had a total knee replacement due to
osteoarthritis. Osteoarthritis causes degenerative changes, within the joints causing bone stiffening
and reactive inflammation. My patient was admitted on 10/21/11 with osteoarthritis and a left total
knee replacement. Her PT and INR were a concern because she had developed mild
thrombocytopenia which resulted in the elevation and potential bleeding. The physician had to take
her off of Lovenox and switch her to an oral anti–coagulant Xarelto at 10mg once daily. During her
care I was educated by the interdisciplinary teams managing mobility, safety, and the more ... Show
more content on Helpwriting.net ...
The agenda was quite clear that during their observations the recovery showed needs were decreased
according to age and BMI. They stated older patients were in need of more assistance and longer
stay in the hospital as opposed to younger adults. I found it interesting that they saw patients with
bilateral knees had decreased needs and that unilateral were in need of more assistance before
discharge. Managing pain was their first priority during research and rehabilitation, followed by
instructing care of their own surgical wound. The aim of this study was to actively reinforce
assessment and management after this procedure and giving guidance to those in health care.
According to Su et all (2009), knee replacement is an effective way to find relief of pain and
improve mobility, but most importantly giving the patient education and skills during early recovery.
In comparison, all articles focused on the need of improving mobility after surgery. Assessing the
patient's abilities and the need for physical therapy and keeping an eye out for complications. A
main focus was pain relief and that recovery for each patient varies, but it is important to get them
ambulating with assistive devices soon after surgery. My patient at Kindred, had continuous
assessment and an interdisciplinary team that assisted in her road to

Evaluation Of An Individual Living With Osteoarthritis (...
Introduction
The following is a report of a subjective interview in relation to an individual living with
Osteoarthritis (OA). The participant was an 80 year old female who lives independently with her
husband, with symptoms mostly affecting her hands and feet, as well as previous history of knee and
hip problems. The interview was conducted in a room in AD block at AUT Akoranga campus where
both the participant and all three students were present. The interview was recorded and analysed
using an audio recorder and written notes, with one student assuming the role of the interviewer and
the others documenting the interview, all done with the consent of the participant.
The model of health being used will be the Te Whare Tapa Wha model. The Te Whare Tapa Wha –
meaning strong house – is a Maori model of health which links the power and symmetry of four
walls of a house to different aspects of health. There are four aspects of Te Whare Tapa Wha these
are taha hinengaro (mental health), taha whanau (Family), taha wairua (spiritual) and taha tinana
(physical). All four aspects relate to each other, and cannot contribute to health without the other,
just like how walls of a house cannot contribute to holding the roof without each other (Durie,
1998). The 3 main themes that were expressed in the interview were her positive outlook on the
condition, the importance of a wider support network and mainly how proper education on the
condition can influence how the condition is

Risks Of Knee Replacement Surgery
The knee replacements is a procedure that is carried out for the treatment of a knee joint that has
been damaged because of osteoarthritis, in which there is a breakdown of joint cartilage as well as
the underlying bone. Just like any other operation, knee replacement surgery has risks as well as
benefits. In most of the cases, the knee replacement result in serious complications, but in some
people it does.
Here are some of the risks that are involved in this kind of surgery:
Anesthesia risks: The anesthesia is considered to be safe, but they can result in minor side effects
that includes sickness and confusion. There is also a slight risk of serious complications as well. The
patients who have existing heart disease, lung problems, or other

Knee Replacement Procedure
If you will become one of the millions to undergo a knee joint replacement Frisco TX,
understanding the proper steps to take during recovery is imperative for your surgery's success.
Fortunately, 9 out of 10 patients who undergo this procedure see immediate improvement in their
mobility and a large decrease in their pain. Without proper recovery, your knee replacement may not
be as successful, so use these tips after a knee replacement to ensure an effective surgery.
Recovery Immediately after Surgery
You will need to remain in the hospital for a few days after your surgery. This time will allow the
surgeons to monitor your post–operative progress. During this time in the hospital, you will
experience some pain and discomfort after surgery

Essay about Heritage and Health Assessment
Running head: FAMILY HEALTH ASSESSMENT
Family Health Assessment
Grand Canyon University
NRS 429 V
August 15, 2012
Family Health Assessment "A family is a set of interacting individuals related by marriage, blood,
and adoption or by cohabitation interdependently perform relevant functions to fulfill expected role"
(Edelman & Mandle, 2010). Systems theory allows a nurse to view patient as a whole family unit,
which the action of each member will influence one another. Family developmental theory is to
assist the patients through every stage of life. Gordon's functional health patterns are eleven
principles incorporated with the nursing process to collect data, assess patients and families, and
provide a diagnosis for ... Show more content on Helpwriting.net ...
As children this author and siblings took naps when the father took naps when out of school for the
summer. The parental grandmother would make the father take naps as a child and he passed this
upbringing on to his children. The stepmother sleeps well at night and wakes up with tons of energy
in the morning. This author takes sleep aids due to sleep deprivation from working the night shift.
The younger siblings sleep at night and attend class throughout the day no sleep issues were
reported. Elimination As a result of eating fresh fruits, vegetables and consuming lots of water daily
no one has bowel or bladder problems. Activity / Exercise Prior to the father having knee surgery he
would play handball three sometime four time a week. He currently swims three times a week at the
neighborhood YMCA and walks frequently with the dog. His wife is a Zumba dance instructor and
holds classes five times a week. This author and siblings participated in tennis lessons, track, dance
classes, and riding their bikes as children. This family gets together often for family gatherings and
activities. Cognitive This family communicates well with each other; their primary language is
English. The two youngest daughters are fluent in Spanish and English. Their biological mother is of
Puerto Rican culture. The father graduated from St. Louis University with a Masters Degree in
business

Questions On The Practice At A Semester II Level
Current review for VTE prophylaxis
Shubhreet Malhi
300192775
Table of Contents
Introduction.....................................................................................................3
Analysis and Synthesis.......................................................................................4
Implications to the practice at a semester II level.........................................................6
Impact on the nursing care and or health care.............................................................8
Conclusion....................................................................................................10
References.....................................................................................................11
Appendix A: Matrix Table...................................................................................3
Current review of VTE prophylaxis
INTRODUCTION
Throughout the surgery, numerous complications arise despite the proper planning. Perhaps, one of
the most dangerous complication is the Venous Thromboembolism (VTE) – a broad concept which
encompasses Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). The risk for VTE after
surgery is further increased and in absence of thromboprophylaxis, it is associated with high
mortality rate of 40–60% (Liu et al., 2016). Hence, VTE prophylaxis guidelines recommends the use
of pharmacological prophylaxis such as warfarin, low molecular weight heparin (LMWH).
However, the chemical therapeutic agents are associated with increased risk of bleeding,
intraoperative hemorrhage and hematoma (Frostick, 2016). This further results in delayed wound
healing, infection and high risk of readmission (Nam et al., 2015). Therefore, this paper explores is
the cooperative effectiveness of mechanical prophylaxis such as mobile Compression Devices

Case Study: Osteoarthritis with a Total Knee Arthroplasty
Case Study: Osteoarthritis with a Total Knee Arthroplasty
Holly N. Pittman
Missouri State University – West Plains
Patient History DN is a 68 year old Caucasian male who lives in Pomona, Missouri. On September
14, 2009, DN underwent a scheduled left total knee arthroplasty at Baxter County Regional Medical
Center. A consultation appointment about a total knee arthroplasty was scheduled when DN had
increasing pain in his knees while doing chores and working on his dairy farm. The increasing pain
DN was having been due to a history of osteoarthritis and the wear–and–tear on his joints
throughout his life, no specific injury was noted. Depending on the outcome of the left knee, DN
was consulted on having his right knee done in the future ... Show more content on Helpwriting.net
...
There was no hearing deficit noted with normal conversation. Patient only had complaints of pain at
surgical site after ambulation, physical therapy or the CPM. Patient was taught he could ask for the
pain medicine prior to these events to hopefully avoid intense pain.
Current Medications Throughout DN's hospital stay he was prescribed medicine to alleviate the pain
caused from the total knee arthroplasty, help prevent any infection that had potential to be a
problem, and prevent any complications. DN's current medications while in the hospital were as
follows: 1.) Docusate–Senna (Trade Name: Peri–Colace) 1 tablet by mouth, twice a day; used for
softening and passage of stool for the relief of constipation caused by post operative anesthesia and
decreased activity (Deglin & Vallerand, 2007). 2.) Enoxaparin (Trade Name: Lovenox) 40 mg
by subcutaneous injection, once every morning; used for the prevention of thrombosis formation
(Deglin & Vallerand, 2007). 3.) Psyllium (Trade Name: Metamucil) 1 tablespoon by mouth,
twice a day; used for relief and prevention of constipation (Deglin & Vallerand, 2007). 4.)
Acetaminophen–Oxycodone (Trade Name: Percocet 5/325) 1–2 tablets by mouth, every four hours;
used for decreasing pain as well as decreasing a temperature (Deglin & Vallerand, 2007). 5.)
Magnesium

The Importance Of Personal Counseling In Nursing
A patient on the nursing unit had a right knee replacement, and the patient is post–operative day
two. The patient did not complain of pain, but the staff could tell that the patient was in pain because
the patient would grimace when she was moved. The patient's sister was also present at the bedside,
and the sister would answer for the patient majority of the times. After the sister left in the
afternoon, the patient's own personality started to shine, and a better relationship was gained with
the patient because she was able to express her own needs. This event was a significant event in the
ways of knowing because the patient had a quiet voice when the sister was present, but when the
sister left, the patient developed her own voice. Personal knowing is important in this situation
because it allows nurses to actually listen to what the patient is saying to develop a therapeutic
relationship with the patient (Fawcett, Watson, Neuman, Walker, & Fitzpatrick, 2001). Overall, the
therapeutic relationship was not completely built until after the patient's sister left, and the patient's
own voice was heard. During this situation, feelings were mutual because the patient was becoming
frustrated with the sister because the sister was not allowing the patient to be her true self. There was
a gut feeling by the nurses that the sister was overbearing to the sister because she would not let the
patient answer for herself most of the time, so the nurses decided that it would

Symptoms And Treatment Of A Knee Replacement
A total knee replacement is a surgical procedure in which the articular surfaces of the tibia, patella,
and femur are replaced with prosthetic devices. It is performed to relieve pain from joints that have
not been controlled by other methods of pain management. There are varieties of reasons a patient
might need a knee replacement including rheumatoid arthritis, post traumatic arthritis, congenital
knee deformity and in the case of my patient, osteoarthritis which is also the most common type of
joint disease. Osteoarthritis happens when cartilage that covers the ends of the bones where they
meet joints break down and deteriorate. When this happens, the bones and the joints now rub
together. Sometimes the bone will grow causing bone spurs and make it very painful and stiff to
move around. Physical examination is important in making the diagnosis of this disease. Pain on
range of motion and limitation of range of motion are common to all forms of osteoarthritis, but
each joint has unique physical examination findings. Because osteoarthritis is primarily a clinical
diagnosis, physicians can confidently make the diagnosis based on the history and physical
examination. Plain radiography can be helpful in confirming the diagnosis and ruling out other
conditions. Advanced imaging techniques, such as computed tomography or magnetic resonance
imaging, are rarely needed unless the diagnosis is in doubt and there is a strong suspicion for
another etiology, such as a meniscus

Knee Replacement Research Paper
The development of 3D printing has greatly impacted the medical field, more specifically knee
replacements. With the new development of 3D printing, patients have experienced a shorter
recovery time, less pain, and more mobility.
"Off–the–shelf implant can take up to 12 weeks to fully recover. With the use of customized
implants, some patients report that they are able to walk without assistance or pain in as little as two
to six weeks," (The perfect fit). With 3D artificial joints doctors are able to take a CT scan of your
knee, then create a perfect mold for your knee. Since the artificial joint fits so well, this often leads
to less swelling, less bleeding, and a faster recovery time. According to Chuck Sharpe, "Within a
week after surgery I threw away the cane and crutches. Now it feels like my natural knee, it really
does," (3D Printing Changing Total Knee Replacements). Doing any type of physical activity, there
comes a great deal of pressure on your knees, and legs. Bespoke knee ... Show more content on
Helpwriting.net ...
But now, new 3D technology allows doctors to make knees that are the perfect fit," (New 3D Knee
Replacement Are a Better Fit for Patients). Knee replacements that don't fit correctly, can cause
massive amounts of pain, but 3D technology solves this problem. " Fitch Lockwood has a knee
that's pain free and can bend better than most 64–year olds, " (3D Printed Knee Replacement Could
Offer Decades of Pain free Mobility). With no pain, people, and the elderly can move around longer
with having to say the dreaded words, "I need to sit down for a little bit." There are many skier that
get this procedure done, because of it can do in the long run, "Duggan had a knee replaced on Sept.
17 and the other done on Nov. 19. He had been in so much pain that even right after his first surgery
he felt better" (Finding a Perfect fit in knee

Knee Replacement Case Study
DOI: 3/31/2016. Patient is a 58–year–old male driver who sustained injury when he was hit by a
vehicle. Per OMNI, he was diagnosed with right knee sprain/contusion.
MRI of the knee dated 7/15/16 revealed no meniscal tear, ligament rupture, or other acute injury.
Based on the progress report dated 08/17/16, the patient continues to have right knee pain without
significant improvement, however, he does get some substantial relief when he wears a right knee
brace. The medications give him functional improvement and pain relief.
On examination of the right knee, there is tenderness to the medial/lateral joint lines and
patellofemoral facet. Range of motion (ROM) is 0–135 degrees.
IW was diagnosed with right knee contusion, right knee pain and ... Show more content on
Helpwriting.net ...
Treatment plan also includes Vascu–Therm post operatively for cold therapy with deep vein
thrombosis prophylaxis, post–operative physical therapy, three times per week for six weeks, and
preoperative clearance prior to the surgical procedure to determine the patient is safe to proceed with
surgical intervention.
Per verification to the provider's office, the patient has not had any injections and there is no
available information on the number of PT visits attended to date.
Patient has been previously denied with 1 Right Knee Diagnostic Arthroscopy on 08/04/16 (Review
270777).
Current request is for 1 Right Knee Diagnostic Arthroscopy between 8/29/2016 and 10/28/2016; 18
Physical Therapy Sessions for the Right Knee with Evaluation between 8/29/2016 and 10/28/2016;
1 Month Rental of Home–Based Transcutaneous Electrical Nerve Stimulation (TENS) Unit for
Post–Operative Use between 8/29/2016 and 10/28/2016; 1 Pre–Operative Clearance between
8/29/2016 and

How To Avoid Knee Replacement Surgery
Treatment Tips that will help you Avoid Knee Replacement Surgery
The two main types of arthritis are namely; rheumatoid arthritis and osteoarthritis. Each of these
conditions affects the joints differently. The main risk factors for arthritis include obesity, previous
joint injury, sex, family history and age. For example, arthritis of the knee occurs as we grow older.
The condition can be worsened by a previous incident of knee injury. When it comes to non–
invasive treatment intervention for arthritis, there are several treatment procedures and prevention
measures that will help keep your knee joint healthy in order to avoid invasive knee surgery.
Treatment Tips to Avoid Knee Replacement Surgery
Hyaluronic acid (HA) injection
HA injection

Knee Replacement
Knee Replacement The most common complication is blood clots after the knee replacement
surgery and can form in the first four weeks. Infection is the most serious complication since it can
be a deep infection and requires removal of the knee replacement to fight the infection. The most
important long–term complication is loosening and wear. This complication is due to the plastic
plate wearing away and the knee becomes loose causing the patient pain and discomfort. New
technologies and methods have been developed to reduce loosening and wear of the knee.
In my family, I would highly recommend a knee replacement due to the new technologies for knee
implants. I can see myself getting a new replacement and be looking forward to getting mobile

Case Study On Knee Replacement
1. My mother has knee pain for many years and recently it has worsened. She has some deformity
around the knees and can barely walk more than 10–15 minutes. What should be done?
Recent worsening of chronic knee pain and deformity probably indicates that knee arthritis has
reached advanced stage i.e. the protective lining of the joint is nearly completely worn out. At this
stage, pain medication often doesn't help much. Rather, one may suffer from dangerous side effects
of prolonged pain medication therapy on heart, liver, kidney, stomach and intestines. It is
recommended that one should consult a joint specialist and get certain X–rays. If it is advanced
arthritis, then one should consider knee replacement to get rid of the problem.
2. What do you mean by knee replacement?
It is a surgical procedure in which the damaged or worn out cartilage lining of the joint is removed
and replaced with an artificial implant thus removing the cause of pain. The soft tissue tension
around the joint is balanced and the joint axis is restored to ... Show more content on
Helpwriting.net ...
What is the role of physiotherapy and exercises after joint replacement?
At Paras Centre for Joint Replacement, we believe that every patient is unique. Therefore, we
customize the physiotherapy protocol for the patient during the post–operative recuperating period
depending upon the intra–operative observation of patient's bone & soft tissue quality, soft tissue
balancing, deformity and so forth. So our team of expert rehabilitation specialists rigorously trains
the patients with the simplified protocols under the personal supervision of surgeons so that what
you get is "Just what is precisely tailored for you". More than 95% patients (except the unreliable
ones) do not need supervision of physiotherapist at home as they are able to follow the custom–
made exercise regimen taught to them during hospital stay at home very well. Our surgical team
vigilantly keeps track of the patient's performance at home by meticulous follow

Therapist's Goals And Intervention Case Study
Therapist's goals and interventions The patient had a routine knee surgery with a protocol based
recovery plan. The therapist still completes an assessment, but it is a specific one tailored to joint
replacements. It is known as the 'post–op joint replacement/fracture' assessment form. The
appearance of the limb is assessed (swelling, color, temperature, stiffness). ROM, gait pattern, and
amount of pain the patient is experiencing is also considered. Based on the observations made
determine which goals and plans are made. In the case of patient J.M the three goals were made. The
first was to achieve –5 to 105 degrees of flexion in left knee. This was to be achieved through TKA
(Total knee arthroplasty) protocol progressive exercises. The second was to increase functional
strength in left leg and be achieved through progressive exercises as per TKA protocol. ... Show
more content on Helpwriting.net ...
The PTA supervising me would guide me when she believed the exercises could be progressed or
altered for the patient. For example, the patient was not able to obtain more ROM after completing
the stretches so the PTA added a gastrocnemius stretch with a wedge as well as a passive
gastrocnemius stretch using a ankle weight. Teaching Techniques My participation with these
stretches were to demonstrate what to do and to observe the patient completing the actions correctly.
One of the large concerns with the wedge stretch was that the patient tried to 'bounce' further into
the stretch. This is incorrect and can cause micro tears in the muscle tendons. For reasons similar to
this, 'tell me, show me, watch me do it' as found in Sadowsky's client instruction PowerPoint (2016),
was used. Unfortunately, I was not involved with the discharging of this patient. As he was only
assigned to PTA's for the protocol exercises and stretching, and nor for the final assessment.
Evaluation of Involvement Developing Relationships and

Essay On Knee Replacement Surgery
A patient arrives at the hospital for their knee replacement surgery that has been scheduled for today.
The patient is checked in at admitting and is called back to the pre–operative area by the nurse. The
patient changes and the nursing staff begin to take the patient's vital signs, review the patient's
history, draw blood for lab work and they let the patient know what to expect before, during and
after surgery. The surgeon arrives and checks in with the patient, asks if they have any final
questions before surgery and then leaves for the operating room to prepare. The patient is taken to
the operating room, anesthesia is given, and the operation begins. The procedure goes smoothly and
the patient is taken to the post–op area. When the patient comes out of the anesthesia, the surgeon ...
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Each step along the way, the person(s) involved thought that confirmation of the knee being
replaced was the responsibility of the other. The surgeon also may have acted based on their
memory of the patient, however, memory should never be used as the sole resource for patient
information. The average orthopedic surgeon in the U.S. can see anywhere from 20 – 80 patients per
week, depending on their individual schedules and preferences. That is far too many details to keep
clear in one's memory.
What other problems surround the occurrence of the central problem?
Often there are delays in surgeries. Some operations can take longer than expected, unexpected
emergencies come up. Staff can feel rushed to move forward to prevent further delays. Also, there
can be times when staff are overworked due to being short–staffed. Being overworked has the
potential for fatigue causing staff to be less aware and skip or forget about steps in an otherwise
established process.
Step Four: Identify the Root Cause(s)
Why does the causal factor exist?
A complete breakdown of the communication chain occurred, resulting in the surgeon relying on

A Good Candidate For A Total Knee Replacement
There are several factors that go into considering if you may be a good candidate for a Total Knee
Replacement. One of the most common causes could be due to all forms of arthritis; such as
osteoarthritis, rheumatoid arthritis, and even post–traumatic arthritis. Osteoarthritis is the most
common reason for needing a Total Knee Replacement. Arthritis can severely damage an
individual's knee, causing massive pain. However, the first approach is trying the nonsurgical
treatments first. Medications and even using walking supports are usually the first approach before
considering surgery. When these methods fail to work the very next step is for surgery. Total Knee
Replacements are the most successful procedures in all of medicine, accounting for 600,000 knee
replacements each year in the US. The knee is the largest joint in the body, which is why it's very
important to have healthy knees in order to get around to perform daily activities. The knee consist
of the lower femur, the upper end of the tibia, and the patella. The ends of the three bones touch,
which is covered with articular cartilage, this is a smooth substances that protects the bones and
enables them to move smoothly. Also, located between the femur and tibia are the menisci. The
menisci are C–shaped wedges that act as "shock absorbers" this provides cushion for the joint as
well. Then, the large ligaments also play a role as well, they hold the femur and tibia together to
provide stability. The long

The Incidence Of Aki Between Two Perioperative Antibiotic...
Anecdotal evidence suggested an increase incidence of AKI when gentamicin was used in
combination with cefazolin and vancomycin for perioperative prophylaxis of elective hip and knee
replacements. As post–operative AKI is associated with increased morbidity and mortality, the aim
of this study was to compare the incidence of AKI between two perioperative antibiotic regimens in
patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA).
Methods
This was a retrospective cohort that evaluated 300 patients who underwent elective hip or knee
replacements that received cefazolin, vancomycin and gentamicin or cefazolin and vancomycin for
perioperative antibiotic prophylaxis. The RIFLE classification was utilized to ... Show more content
on Helpwriting.net ...
There was no significant difference in rates of PJI, CDAD, length of stay, need for acute
hemodialysis, or readmission related to AKI.
Background
There were more than 1,000,000 total hip and knee replacements in the United States in 2010.1
Prosthetic joint infections (PJIs) are a rare complication of joint replacements, estimated to be less
than 2% of cases, but result in significant morbidity and increased healthcare costs.2 Frequently, PJI
requires removal of the prosthesis and a prolonged course of IV antibiotics. It has been estimated
that the cost of one PJI is approximately $100,000 after a hip arthroplasty and $60,000 after a knee
arthroplasty.2 Perioperative prophylactic antibiotics for total joint replacements have been proven to
reduce rates of surgical site infections.2–3 It is recommended that prophylactic antibiotics are
administered within one hour prior to surgical incision and are discontinued within 24 hours
following the end of surgery.4 First generation cephalosporins, such as cefazolin, are the agents
most commonly utilized for antimicrobial prophylaxis in joint replacement procedures.2,5
Vancomycin may be used in addition to a first generation cephalosporin in institutions considered to
have a high rate of methicillin–resistant staphylococcus aureus (MRSA) surgical site infections. 2 If
there is local data to suggest gram–negative pathogens as a cause of PJI then it is recommended to
consider the addition

Reflection
"Slow Is Smooth And Smooth Is Fast" Over the last couple weeks, I have had the amazing
opportunity to work alongside Alex, Shaun, and Lance at the Center for Bone and Joint Disease
(C.D.J.D) in Hudson Florida. I consider myself extremely fortunate for being assigned this clinical
location because I have been exposed to so much in such a short period of time. Not only are Alex,
Shaun, and Lance excellent radiological technologists who are eager to share with me everything
they know, but C.B.J.D. Hudson is incredibly busy because of how many patients are seen there
every day. This has given me countless chances to hone the skills I have learned in the classroom
and has quickly shown me traits and skills I have I am proud to call ... Show more content on
Helpwriting.net ...
Another strength that has helped me is my ability topositioning patients.There are so many different
patients that come to C.B.J.D Hudson with so many different reasons for needing x–rays. Being able
to understand the anatomy of the patient no matter what the body habitus or situation is key. I am
proud of my ability to position a patient who may have a hypersthenicbody habitus and who's
landmarks are impossible to visualize let alone palpate. Other patients I have had to position have
just had surgery and are in a lot of pain and cannot move into the positions you need. Knowing the
anatomy and being creative with positioning these patients is essential to properly demonstrate
exactly what is need to be seen on the x–ray. One position that I am proud I can properly position is
a lateralweight bearing knee which we did not learn in class. It is important that the medial and
lateral condyles are perfectly parallel to one another so there is no rotation. This is especially
important but exceptionally difficulty for a patient who has had a knee replacement. Often the
patient's knees are so swollen you cannotvisualize the condyles and cannot feel them when you
palpate the patients knee. Because I understand the anatomy and how it needs to be positioned for
this image I can complete this x–ray with no rotation. Having a strength in positioning has helped
me obtain quite a few clinical competency requirements these past few

Knee Replacement Case Study
001015 Mr. ___ [NAME] is a 49–year–old white male, a patient of Dr. ___ [NAME], with a history
of right knee replacement x 4, secondary to a gunshot wound in ___ [DATE]. Left knee, he has had
multiple surgeries, primarily on the ligaments and I understand the meniscus. Also has right hip
pain. The hip is probably related to his difficulty with the right knee. He has chronic pain in the
knees. He has a need for testosterone as his labs are very low. PTSD, (___) anxiety. Really here
today to follow up on the testosterone. Lab was drawn; other results are not yet available. His non–
fasting glucose today was 106 and the hemoglobin A1c that was done was 5.9. He does have some
history of hyperglycemia, but I think there were primarily non–fasting, he may just have some
glucose intolerance. Complains primarily of knee pain and right hip pain. He is having erectile
dysfunction, was given Viagra, and when he saw the urologist he was told that he needed
testosterone, as it was quite low at 1.8. ... Show more content on Helpwriting.net ...
Blood pressure is a little bit low at 84/68. Heart rate is a little bit rapid, but his knees positive (dorsi
aling) both. Right is particularly bad, it is extremely loose. The left is also quite loose, but perhaps
not as bad the right. There is a lump on the right hip. I do not know if it is not fitting entirely into the
socket or if it is just swelling, but it certainly must be difficult for him to

Dr. Lloyd G. Cox Essay
Dr. Lloyd G. Cox, II, M.D., is a Board–Certified Orthopedic Surgeon who has been practicing
Orthopedic medicine for nearly 30 years. As a caring and compassionate surgeon, he is dedicated to
providing the residents of Southern Maryland with the superior Orthopedic care that they deserve.
Dr. Cox is also conservative and only recommends surgical intervention when it is absolutely
necessary. Nevertheless, if surgery is a patient's only option, Dr. Cox provides him or her with the
most innovative products and procedures available. Dr. Cox has served as the team physician for St.
Mary's College Seahawks as well as the Chief of Surgery and Board Member at St. Mary Hospital.
He offers the residents of Southern Maryland a variety of orthopedic services. Dr. Cox specializes in
treating disorders of the hip and the knee. He has experience repairing the Anterior Cruciate
Ligament (ACL), rotator cuff and meniscus by means of arthroscopic surgery. His passion is
precision customized total knee replacements and every aspect of accelerated recovery following a
joint replacement; therefore, he performs partial and total knee replacements using ConforMIS Knee
Implants. These state–of–the–art implants provide patients with a custom–made implant that is
designed specifically to meet his or her unique anatomy. Dr. Cox offers his patients the most
advanced knee replacements available: The ConforMIS Customized Knee Implant. ConforMIS
implants are tailored to the specific characteristics of

The Pros And Cons Of Medicare Essay
Comprehensive Assignment Step 4
In discussion with two families, the pros and cons of Medicare are discussed. Melvin and Barbara
Coats are above retirement age and until recently were both still working. Edward and Betty
Florence are below retirement age, but Edward is disabled and hasn't worked since 2007.
Mr. Coats stated he had a heart attack needing five bypasses if not for his Medicare he would have
lost his business and home due to the medical cost. Ms. Coats has worked and additional ten years
just to be able to pay for her medications. But recently she needed knee replacement surgery and had
quite to work. Again if not for her Medicare the Coats family would have lost everything.
Mr. Florence stated, "I was admitted to the hospital on Thanksgiving Day 2015 with DKA after
seizures, falling, and then vomiting for Twelve hours." His family was told he could die as a result.
He stayed in ICU for six days and three more days on another floor; he was also transferred from his
small hometown hospital to a bigger hospital thirty miles away. If not for his Medicare, his
medications alone could bankrupt his family and cause them to lose everything.
Ms. Coats is appreciative of her Medicare but states, "it does have its drawbacks." While having
knee replacement she developed blood clots in her lungs and Congestive Heart failure in which she
gained seven pounds in two days. After the doctors had started to get this under control, they wanted
to send her to the Hospital

My General Biology And Organic Chemistry Classes
We dedicate years of our lives to attending school in an attempt to gain knowledge. This knowledge
comes to life during our day–to–day interactions with people. In healthcare, this knowledge ends up
being a small element of patient care. Those chemical reactions and disease pathways we so
thoughtfully memorized suddenly are transformed by a patient's story. Each patient has a social,
economic, emotional, physical and cultural history that makes medical care much more than just
writing a prescription to fix a disease.
When I began working as a physical therapy aide I had a tremendous amount to learn. My general
biology and organic chemistry classes did not prepare me for the knowledge I was going to gain
from this job experience. I had a lot to learn about shoulder injuries and knee replacements to be
able to teach patients full exercise routines to help them heal. Fortunately, the physical therapists I
was working with were willing to teach me everything I needed to know about the body and
exercise. I gained a vast amount of knowledge throughout my time working here, but I never
expected the biggest lesson I learned to come from a patient.
I walked into the waiting room, called her name and immediately realized something was wrong.
This normally bubbly, vivacious patient sat still with tears streaming down her face. She had just
received the results of her electromyography, which indicated yet another postoperative
complication of her total knee replacement. She

Total Knee Replacement
Nifedipine (Adalat,Procardia,others) Prototype Drug / .Therapeutic Class: Drug for hypertension
and angina Pharmacologic Class: Calcium channel blocker. ACTIONS AND USESNifedipine is
CCB generally prescribed for HTN and variant or vasospastic angina. It is occasionally used to treat
Raynaud's phenomenon and hypertrophic cardiomyopathy. Nifedipine acts by selectively bloking
calcium channels in myocardial and vascular smooth muscle, including those in the coronary
arteries. This results in less oxygen utilization by the heart, an increase in cardiac output, and a fall
in blood pressure. It is available as extended–release tablets (XL). ADMINISTRATION ALERTS
Do not administer immediate–release formulations of nifedipine if an ... Show more content on
Helpwriting.net ...
Ensure proper use and functioning of any home equipment obtained. | Ensuring therapeutic
effects:Continue frequent assessments as described earlier for therapeutic effects.(Blood pressure
and pulse should be within normal limits or within parameters set by health care provider. If drug is
given for angina and /or dysrhythmias, significant improvement in reports of pain, palpitations, or
ECG demonstrates improvement) | Encourage the patient to adopt a healthy lifestyle of low–fat food
choices, increased exercise, decreased alcohol consumption, and smoking cessation. | Encourage
appropriate lifestyle changes. Provide for dietitian consultation as needed. (Healthy

Total Knee Replacement Case Study
Brief Description of Patient: Patient is a 45 year old male who was diagnosed with osteoarthritis of
his left knee. The pain in his knee was limiting him from doing his job and his every day activities.
The orthopedic surgeon had the patient do physical therapy to see if this would help. The therapy
was not helping the patient so the surgeon decided to do a total knee replacement.
PICO Question: For a patient with a total knee replacement, will the use of a continuous passive
motion (CPM) machine plus standard physical therapy be more effective than just standard physical
therapy to provide an increase ROM and decrease pain?
Databases Searched and Key Words: PEDro– CPM, total knee replacement, physical therapy.
PubMed– CPM, total knee replacement. ... Show more content on Helpwriting.net ...
Overall knee flexion in the patients decreased from baseline after the total knee replacement. Pain in
both groups had decreased, but the swelling in the joint had increased from baseline. Participants
had a harder time ascending stairs after the total knee replacement operation. The results of this
study state that the use of a CPM machine with physical therapy compared to just the use of physical
therapy does not improve knee flexion range of motion, pain level, or the ability for the patient to
walk. There was not enough differences between the two groups to justify the use of a CPM
machine after a total knee

Knee Replacement Surgical
Best knee replacement surgeon in Delhi Major factors to consider before choosing knee replacement
surgeons– Joints and joint related problems are very crucial in human bodies which need to be
treated perfectly by the best knee replacement surgeons from any well known hospital. Joint pains
have always known to be the hardest pains ever when it comes to following the daily routines along
with bearing those pains. The starting stages can be treated really well by medicinal courses or
exercising routines or by physiotherapy sessions given by various well educated, well trained and
well experienced physicians of the specific field. In case the before mentioned methods do not work
out well and the patients are found to be suffering to the extreme

After Knee Replacement Surgery
How Home Health Care Helps You After Knee Replacement Surgery
If you're going to have knee replacement surgery, you should expect to have trouble getting around
well enough to take care of yourself for several days after the procedure. While you'll be in the
hospital a few days, once you've recovered from the actual surgery, you will be discharged to
recover in a nursing facility or at home. If you don't have family to help you, hiring home health
care will allow you to return home to your familiar surroundings to recuperate. Here why a home
health care service is beneficial.
Supervise Medications
You'll be in pain after your knee surgery, and you'll probably be sent home on pain medications to
keep you comfortable. If the medications make you groggy, you may develop irregular sleeping
patterns that interfere with taking other medications on schedule. If you need to take antibiotics or
medications for a condition such as diabetes or high blood pressure, you need to take the drugs on
time. A home health nurse or aide will make sure you take your medications on time. He or she can
also supervise your medications to make sure you take the right dosage since you may have fuzzy
thinking due to pain and narcotic medications.
Encourage Exercise ... Show more content on Helpwriting.net ...
You may have to go to a physical therapy clinic periodically for treatments, but you'll also be
expected to exercise every day at home, even if you're in pain. If you are at home alone, you may
become lax because of pain and grogginess. If you don't keep up with your exercises, your recovery
will be longer. A home health aid will encourage you to do exercises like you are instructed, and will
inform your physical therapist if you can't or won't do them. This helps prevent complications that
slow recovery and reduce range of motion in your

Motivation Of A Patient 's Level Of Intrinsic Motivation
Abstract The overall purpose of this study is to determine if a relationship exists between a patient's
level of intrinsic motivation and success in rehab given two different therapy settings. Determining
if such a relationship exists will allow for doctors and physical therapists alike to guide their patients
more effectively in deciding the most appropriate protocol. The study will recruit 50 participants
aged 65–75 that are scheduled to undergo total knee arthroplasty. The participants will be randomly
assigned to an outpatient physical therapy protocol or to a home–based rehabilitation protocol. Pre–
surgery, they will be assessed on their levels of intrinsic motivation using the Intrinsic Motivation
Inventory. Following a twelve week rehabilitation protocol, participants will have the range of
motion of their knee joint measured using a Chattanooga Group Goniometer. Additionally, they will
have their knee functionality and joint pain measured utilized the Oxford Knee Score. Upon
completion of these measurements, data will be organized and statistical analysis will be performed
in the form of multiple regression analysis. On an individual level, determining if a relationship
exists between motivation type and corresponding success in a given setting has implications in
elevating the level of patient care for orthopedic procedures. The next step in the research process is
to develop additional studies seeking to clarify and address the different and more in depth

Essay about Nursing Instructor
Nursing Instructor
PHYSICAL HISTORY:
My clinical rotation was at St. Francis Hospital on the orthopedic/medical–surgical floor, 5–1. I was
assigned JB for a patient 10/7 and 10/8. He was one day post–op from an elective bilateral knee
arthroplasty.
JB is a 69 year old Caucasian male who stands 6 feet tall and weighs 251 pounds. He has a history
of hypertension, benign prostatic hyperplasia, degenerative joint disease, and renal calculi.
Medications taken at home: Nifedipine 60 mg. QD to manage his hypertension and nonsteriodal
anti–inflammatories for the DJD.
JB's major problem is the degenerative joint disease (DJD) also referred to as osteoarthritis.
According to Colodny, more than 50 million Americans suffer from ... Show more content on
Helpwriting.net ...
JB was admitted to St. Francis on 10/6, the day of surgery. On post–op day one 10/7 his vital signs
were: Pulse–84, Respirations–20, Blood Pressure–130/70, and Temperature 101.5 F. on 10/8 they
were 86, 20, 135/74, and 102.0 respectively. All vital signs except for the temperature were within
normal limits for this patient. He received Tylenol 650 mg. pm every 4 hours for elevated
temperature. Laboratory results showed a low hemoglobin of 8.6g/dl (normal 12–16g/dl) and a low
hematocrit of 25.2% (normal 36–41%). JB received 1 unit (500 cc) of RBCs on 10/7 and 10/8. All
other laboratory values were within normal limits. The primary nurse felt the transfusions
contributed to or caused the elevated temperature because JB showed no other signs of infection
through physical assessment or laboratory values.
JB had clear lung sounds bilaterally. He had palpable pedal pulses and was positive for color,
motion, and sensation in both affected extremities. Capillary refill was less than 2 seconds. His skin
was warm and clean. He was diaphoretic due to an increased temperature. He had a quarter size
reddened area on his coccyx that was being monitored and protective nursing interventions were
instituted to prevent skin breakdown.
JB was oriented to time, person, and place.
SOCIAL HISTORY:

JB was born and raised in Connecticut. He and his wife have been married

Total Knee Replacement Summary
Oliver et al. (2014), exemplifies how some physicians may not be aware of their implicit bias that
could be causing healthcare disparities. This study determines whether physicians' implicit racial
views of African Americans affect their decision making, regarding total knee replacement (TKR) as
a treatment option for OA. They also assessed whether not, if the Racial Implicit Association test
would impact TKR recommendations. In the study implicit bias was determined by the racial
implicit association test (IAT) and explicit bias was tested using a questionnaire that asked
physicians which race they preferred (black or white) using a 5–point Likert scale and 10–point
thermometer scaled to grade physician's feelings.
Osteoarthritis (OA) is a degenerative joint disease, highly prevalent in African Americans. African
Americans men are 3 times more likely then Caucasians men to have involvement of all three
compartments of the knee (Jordan, 2015). Total Knee Replacement (TKR) is a cost–effective
treatment. Nonetheless, TKR rates are lower in African Americans.
Oliver et.al, (2014), hypothesized that IAT before seeing that patient would decrease the effect of
patient race on TKR recommendation. They conducted a web–based study of 543 family and
internal medicine physicians who were divided into two groups. Participants were randomly
selected and ... Show more content on Helpwriting.net ...
Jackson's knee pain was a result of OA. 44% of the doctors (297) recommended TKR for Mr.
Jackson. Participants that completed the racial IAT before making the TKR decision were more
likely to recommend this option (50%) as compared to those who did the Racial IAT after making
the decision (39%). Results from questioner of TKR recommendation during explicit using a 5–
point Likert scale showed a bimodal distribution, highly related with the dichotomous measure (r
=0.75;

Post Knee Replacement Case Studies
In a hospital I worked at recently, I was told in report that a patient I was taking was demented and
didn't know where she was or what her situation was. The patient admitted for a post knee
replacement was 86 years of age, fragile, very hard of hearing and mute. The pain in her knee was
excruciating and she often cried out asking for pain medication. Moving her in the bed also caused
her pain, because she was said to have dementia no one explained to her what they were doing so,
she fought the staff when they moved her or changed her brief. After I came on shift I assessed her, I
attempted to take her knee immobilizer off to assess her knee and she cried out in pain and smacked
my hand aside. I felt so bad for her, I decided to try to yell

Total Knee Replacement Essay

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