Nursing Care for General Anesthesia in Hip Hemiarthroplasty

Abstract

Hemiarthroplasty is the best treatment option for patients with hip fracture. To relieve pain causes by pathological hip area. To maintain the stability and movement of the hip. Resulting in a better quality of life. Currently, the average age of the population increases. Causing more elderly patients, which have deteriorated in both physiological and psychological age, including having chronic illnesses. Making the elderly patient at risk of serious complication such as respiratory complication, delay emergence, confusion, heavy blood loss, proving fluid that results in heart failure and pulmonary edema.

Therefore, studied 2 patients who received general anesthesia in hip hemiarthroplasty

Result of study Case study 1 – Thai female 70 years old, given that 10 days ago, came to slip off the stairs. Doctor diagnosed close fracture left neck of femur. Admitted March 25^th, 2019 treatment by Bipolar hemiarthroplasty left hip March 27 ^th, 2019. Anesthesia risk ASA class 3 (hypertension, abnormal EKG, old age). Mallampati class 1. Received amlodipine (5) 2tab  before receiving the operation room. Use anesthesia methods general anesthesia, intra operation found hypotension 80/60 mmHg. Patient risk of hypoxia and insufficient breathing after surgery due to old age, hypertension, inferior wall infraction, left atrial enlargement. Shivering in recovery room. After solving the problems using nursing procedures to be safe, sent back to ward. Discharge March 30, 2019. Total 5 days in Chonburi hospital.       

  Case study 2 – Thai male 66 years old, given that 2 weeks ago, fell on an ankle turned over. One day before, unable to weigh down. Doctor diagnosed close fracture right neck of femur. Admit April 19^th, 2019 treatment by Bipolar hemiarthroplasty right hip April 25^th, 2019. Anesthesia risk ASA class 2 (ode age). Mallampati class 3 risk for difficult intubation. While induction, maintained airway by oral airway with triple maneuver open mouth, intubate success by video laryngoscope. Intraoperation heavy blood loss must give PRC 1 unit. A lot of pain and confused in recovery room. After solving the problems using nursing procedures to be safe, sent back to ward. Discharge April 30, 2019. Total 11 days in Chonburi hospital.

Both studies show that nurse anesthetists have a role in providing nursing and anesthesia by using nursing procedures. There for pre–anesthesia assessment, planning, and monitoring are very importance for the patient’ safety. So, the patients are safe from the effective treatment and prevent complication from surgery and anesthesia.