Case Study, Joint Replacement Surgery

Submitted by: Maryann Howells, RN Case Manager

Patient Condition

My client returned to her home after having her left knee replaced. She had a very high stress level after her operation because she was in excessive pain and was paranoid that she had a blood clot. She was not eating well, and her overall blood pressure and heart rate were increasing.

Patient Treatment

I was able to help my client by managing her pain: I made sure that she took her pain medication as ordered, and I taught her about pain threshold and the difference between muscle pain and pain associated with a blood clot. I kept in contact with her doctor to ensure that she had no signs of a blood clot, which helped to ease her mind about her condition.

To help her knee heal, I focused on three basic strategies: (1) I increased the amount of protein she was eating, (2) I encouraged her to drink plenty of water, and (3) I had her practice deep breathing exercises followed by physical therapy exercises.

By the end of the second week following her surgery, my client was much more active: she walked around with her walker more often. Even though she still felt pain during her third week following her surgery, we reviewed how well she had progressed overall. My client’s family member agreed that my client had definitely improved her health within the last three weeks because she had observed my client walking more, first with a walker and then improving to just the use of a cane, complaining less and less about pain, eating more, drinking more, and practicing deep breathing exercises to reduce her high stress level.

Patient Recovery

Overall, my client's blood pressure, her pulse, and her pain level decreased once she became compliant with her pain medication and felt no more worry about a blood clot. We discharged her with all of our goals met, and she continued with outpatient physical therapy.

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