Elderly Nursing Care for Osteoarthritis with Co-Morbidities undergoing Total Knee Arthroplasty : 2 case studies

Abstract

     This study was case study aimed to study elderly patients with osteoarthritis and comorbidities who received knee replacement surgery. to compare Causes of disease, symptoms, treatment, complications using content analysis methods. From medical records, observations, and interviews Assessed according to Gordon's 11 health assessment framework. Nursing practice according to the nursing process concept. Define nursing diagnosis Summary and evaluation of results in the preoperative period. after surgery rehabilitation and continuous care Using Roy adaptation theory to nursing practice in this phase. So that patients and families can learn Promote potential to adapt appropriately The study period is January 2023 - August 2023.
     The results: factors promoting the development of knee osteoarthritis in the two elderly case studies were the same: increasing age Resulting in osteoarthritis. By case study 1 A chubby elderly woman before surgery had her high blood pressure controlled with regular medication. Treated with surgery: Bilateral Total knee arthroplasty (TKA) with medial release by performing an epidural block in bilateral TKA, managing pain with Epidural morphine 72 hours after, and exercising both knees On CPM (continuous passive motion) 0-120 degrees. Practice. Walking with a walker frame, length of stay in hospital 8 days, case study number 2 A very old woman with a thin build He has a chronic kidney disease, stage 4. chronic anemia and high blood pressure with intermittent medication use Treated with Left knee arthroplasty. After 24 hours of surgery, there was acute chest pain. Treated with ASA gr.V, Palvix, Enoxaparin. After 48 hours of surgery, symptoms improved. Exercise the left knee joint. On CPM 0-90 degrees and practice walking for a period of time. Stayed in the hospital for a total of 10 days. Both case studies made an appointment for follow-up treatment for  2 weeks. The second case study made an appointment for knee joint rehabilitation at the physical therapy department. Khon Kaen Hospital every day