Nursing Care Plan for Hip Replacement Revision

HLTEN503A Contribute To Assessment And Developing Nursing Care Plans

QUESTION 1: What are the specific health challenges and factors affecting Ms. Janisevic’s need for a hip replacement revision?

The patient, Ms Janisevic, is clearly suffering from a range of diseases and is under various types of medication that have led to the deterioration of her health. Her medical records indicate a hip transplant that she underwent twenty-three years ago with a serious need for revision. She also is of a very advanced age group, which in most cases is associated with various types of diseases. Research has undoubtedly proved that people of advanced ages, especially women, tend to need company around them. This is also advisable since it reduces stress, depression, and other diseases associated with it. Failure to provide sufficient company and friendly surroundings leads to the exact opposite. This explains why most old people die of various diseases that were hardly traceable in their earlier ages.

In the case of Ms. Janisevic, she has had the replacement for twenty-three years, as mentioned above, with a series of medications such as Digoxin, Frusemide, Oral Hypoglycaemic medication, Panadeine for pain relief, Coloxyl, and sennacot. Besides her lack of sufficient company for her daughter, the revision of the replacement may be caused by stress and old age. It is also evident that her medical history is not as clear, and in certain instances, she has suffered from type 2 Diabetes and chronic Atrial Fibrillation. The detection of these two diseases may have hindered the detection of the need for the revision. The reason may also be the inability for her to accommodate all the medication correspondingly, thus the need to carry out one process at a time to put her health into consideration.

QUESTION 2: How does Ms. Janisevic’s age and history of hip surgery impact the need for and complexity of the revision surgery?

According to Engfer and Fairview Health Services (2007), “Younger people who have a hip replaced are more likely to need a second surgery. That’s because the new parts can wear out earlier, since younger people are often more active than older people” (Pg 67). Clearly, Ms Janisevic was not very old at the time of her first surgery. In the United States of America, a sixty-year-old woman is considered not very old and still capable of a whole lot of activities if determined. The author also relates to the case in the sense that the lady in question would find it more difficult to stay at home idle in the earlier twenty-three years when the surgery was done in order to avoid boredom. This could have been a reason leading to a faster wearing out of the tissues replaced, thus the need for another. A nursing care plan should be devised for utmost care and treatment since, as most medics argue, it is a very delicate procedure. According to Cluett (2010), “revision hip replacement surgeries are more complicated, and the results of surgery are not as good. Because of this, orthopedists make every effort to delay hip replacement until an age where the hip implant will hopefully last the patient’s lifetime.” Thus, due to her age, it will be advisable to carry out the revision but with intensive care as well.

QUESTION 3: Why is it important to carefully observe Ms. Janisevic during her recovery process before discharging her from the hospital?

Cluett (2010) clearly argues that “… new developments in types of hip implants are constantly being investigated. Ceramic hip replacements are among the new prosthesis types being implanted into some patients.” Thus, due to the sensitivity of the process and the increasing invention of the new procedures, the patient should be adequately observed before discharge. This is necessary so as to cater for any chances of failure in the process or inadequate response. Similarly, the patient is quite old and has limited access to her daughter, with whom she might be most comfortable. Therefore, the hospital management should ensure full recovery on her part before the decision to release her is made. Release is also based on the patient’s willingness to leave the hospital and take care of herself according to the medication given. This is because the level of recovery is, at times, psychological.

References:

Cluett, J. (2010). Ceramic Hip Replacement Surgery. Orthopedics. Retrieved from http://orthopedics.about.com/od/hipkneereplacement/i/ceramic.htm

Engfer, L., & Fairview Health Services. (2007). Your Guide To Total Hip Replacement. Minneapolis, Minn: Fairview Press.

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