Nursing care in Total Knee Arthroplasty and Hypoglycemia: Case study

Abstract

Thai female patient, 64 years old, diagnosed with osteoarthritis right knee has a diabetic disease. After total knee arthroplasty under SB was performed, surgical wounds, general symptoms and vital signs was stable. The day after surgery, patients with hypoglycemia is treated with glucose and venous fluid substances and control blood sugar into normal levels. The patient was wound dressing and rehabilitation until she can walk to partially weight bearing by walker. The right knee can flexion 110 degrees and good dry wound. The doctor discharged the patient, go to wound dressing at the public health facilities near the house, 1 time per day and for a total of 14 days, stitch off, follow up at the diabetes clinic, and follow up orthopedist for 2 weeks. Important problems and nursing care are anxiety about the practice before and after total knee arthroplasty, risk of shock due to postoperative blood loss, hypoglycemia, discomfort from wound pain total knee arthroplasty, There is a chance of repeated hypoglycemia due to insufficient knowledge of self-care, the possibility of infection in the knee replacement surgery, a chance of deep vein thrombosis, There is a chance of falling while walking, anxiety due to lack of understanding about self-care when come back home. The total length of stay was 12 days.

The nurse's role is very important and must have the knowledge, skills to assess patients correctly and quickly. Nursing care of total knee arthroplasty in the elderly. The body will have a lot of bleeding, infections and diabetes, and hypoglycemia after surgery, which is an emergency. If not corrected in time, the patient will die, so that the patient timely and correct treatment. Able to give advice to patients and relatives in taking good care of themselves, and the doctor allowed the patient to go home.