Nursing HDP401 Lecture Notes - Lecture 14: Shortness Of Breath, Tylenol (Brand), Defecation
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Total knee replacement scenario: a patient has just returned from the pacu post left knee arthroplasty. Summarize the priority assessments a nurse should complete. Assessment of vital signs is a priority initially to patient return to the unit from pacu. Particularly, assessment of pain levels, blood pressure, respiration and temperature. Lower extremities for warmth, colour, pedal pulses, capillary refill time, swelling and range of motion. Incision site for redness-bleeding-discharge amounts, warmth, swelling, numbness, stiffness etc. Any chest pain or shortness of breath: identify at least 3 possible complications post- surgery in each of the following systems: Loss of sensation to leg(s); patient may state not having any feeling in leg upon stimulation and not able to tell if their leg is present. Confusion; disoriented to time, place and person. Hypotension (hypovolemic), tachycardia; dizziness, dehydration, cool clammy skin. Poor circulation; capillary refill greater than 3 seconds. Clots; edema of lower limbs (pulmonary embolism), swelling,
