PRN0098C Chapter Notes -Joint Replacement, Orthotics, Arthroplasty

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alexandrasearle

31 Jan 2023

School

SJRSC, St Johns River Community College

Department

Nursing And Allied Health

Course

PRN0098C

Professor

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Document Summary

Some of the most common conditions are fractures, joint replacements, and lower limb amputations. Sprain: an injury to a joint that results in damage to muscles and ligaments. Ice: first 48 to 72 hours after injury to decrease swelling and pain. Elevation: above the hear to help decrease swelling and pain. Range from narrow crack (hairline fracture) to a bone broken into many small pieces. Broken ends of bone must be supported in close proximity to one another for 4 to 8 weeks or longer to allow the bone to grow together. Joint replacement (arthroplasty): surgery to remove damaged articular bone surfaces and replace them with metal and plastic surfaces. Oa causes degeneration and inflammation of joints over time. Amputate: surgically remove a limb that is so damaged by trauma that it can"t be saved. May also be due to cancerous tumors, severely decreased blood flow to the limb, and gangrene (death of tissue) in a limb.

Related Questions

#10 A patient is admitted as a hospital inpatient with a diagnosis of possible myocardial infarction. During admission, the patient falls while walking and fractures his left hip. Which present on admission (POA) indicator applies to the left hip fracture diagnosis?

a. Y (present at the time of inpatient admission)

b. N (not present at the time of inpatient admission)

c. U (documentation is insufficient to determine if condition is present on admission)

d. W (provider is unable to clinically determine whether condition was present on admission or not)

StewartRenee

CASE STUDY:

Jolinda Hobble had a history of her left knee slipping out of joint since 1998. She went to see Dr. Ralph J. Verygood, an orthopedic surgeon who recommended corrective surgery after Jolinda had a major dislocation of the left kneecap in July of 2000. As a result of this surgery, Jolinda suffers from palsy of her left foot, a condition evidenced by numbness in her big toe and three adjoining toes, the numbness extending about half way up her foot on both the top and the bottom. Jolinda was advised that she might still experience postsurgical knee problems, including inability to walk altogether. She also says that she was not specifically warned about possible postsurgical numbness to either her left leg or foot. Dr.Verygood says that he did indeed warn Jolinda about this possibility.

The surgery was performed July 31, 2000. Jolinda was placed under general anesthetic and remained unconscious throughout the operation. Dr. Verygood performed a surgical procedure which has the effect of realigning the entire mechanism controlling the kneecap in order to correct the knee dislocation. During the operation a pneumatic tourniquet was applied to Jolinda's leg to help the operation procedure by cutting off the blood supply to the leg to create a dry (bloodless) surgical field. Following surgery Jolinda's leg was wrapped by Nurse Vicky with a padded dressing consisting of expandable bandage extending from the toes to the top of her leg. Nurse Vicky is an employee of the hospital.

Dr. Verygood was scheduled to take a few days vacation after the operation, but he nevertheless checked on Jolinda in the recovery room within one hour of the surgery. He also wrote detailed orders to be followed during his absence.

Jolinda says that she first awakened around dinner time on the day surgery was performed, but that she did not regain full consciousness until the following morning. At that time she became aware of a throbbing pain in her left leg which was concentrated on the knee and foot. Jolinda first complained about the pain to the hospital nurse, Nicky the morning after surgery. Nothing was done about the pain, however, until she was checked by Dr. Greatman, Dr. Verygood's partner, on the second postoperative day. Following Dr. Greatman's visit, Jolinda's bandages were cut off in the foot area giving her some relief and after which she experienced a tingling sensation throughout the whole foot.

Jolinda received follow up care from Dr. Verygood after surgery for about one year and during this time period Jolinda's complaints of pain and numbness in her left foot continued.

Here is some more information to consider: You end up hiring for your expert, Dr. Richard Cutgood, a board certified orthopedic surgeon, who had performed literally thousands of knee surgeries in his medical career. Dr. Cutgood is of the opinion that the risk of the type of injuries Jolida has following this type of surgery was statistically nonexistent.

Dr. Cutgood concluded that the most probable cause of plaintiff's injury was external pressure either from the tourniquet used during surgery or from the application of tight bandages after the operation. He considered the probability of nerve damage during the actual surgical procedure to be small because the surgical knife "isn't long enough to reach over and cut that nerve." Regarding the tourniquet, from his experience tourniquet pressure ordinarily does not result damage to the nerves unless "it is incorrectly applied or it is applied over a bony prominence or the tourniquet itself is defective."

Dr. Cutgood stated that while nothing in the record indicated that defendant did anything wrong during the surgery, he was of the opinion defendant was "below the usual and customary standard of care" as such result "does not generally occur without some untoward action of the surgeon."

Does the doctrine of Res Ipsa Loquitor apply to this case? What does this legal term mean? What are the conditions that need to be present for this doctrine to apply?

ibarra091521

How many calories in that fast-food meal? Ontario menu labelling legislation takes effect
Jan. 1
CBC News · Posted: Dec 29, 2016
Restaurant-goers in Ontario are going to notice a little extra something on some menus as of Jan.
1: calorie counts.
Legislation that comes into effect Sunday under the Healthy Menu Choices Act, 2015 requires
that all restaurants with 20 or more locations must clearly display the caloric information for any
food and drink items.
Not only will the information have to be on menus, but it will also need to be clearly displayed
on menu boards and even on restaurant apps. Hospitals, schools, daycares and correctional
institutions are exempt.
The Heart and Stroke Foundation supports the initiative, believing that providing people with
more information helps them make better choices.
"Menu labelling is one small thing that empowers parents and empowers Ontarians to take
control of the choices that they make when they're having lunch or dinner at a restaurant," said
Joe Belfontaine, executive director of the Ontario branch of the Heart and Stroke Foundation.
"Certainly it's not the end-all or be-all, but it's an important tool in the toolbox."
Although Ontario is the first province in the country to require nutritional labelling at restaurants,
Belfontaine said that he hopes other provinces will follow suit.
Will it make a difference?
Whether including caloric counts will have any lasting health benefits, however, is questionable.
New York City has had food labelling requirements at restaurants since 2008. Since then,
researchers have attempted to ascertain whether it's made a difference to the city's population.
Calories of each food item appear on a McDonald's drive-thru menu in New York City. The city
made it mandatory for restaurants to display nutritional information since 2008. (Associated
Press)
A 2012 study in the American Journal of Public Health concluded posting calories on foods had
no direct impact on what foods people chose to buy. Over time, it appeared that people simply
ignored the labelling altogether.
A more recent study from Tulane University suggested that the New York City mandate
"plausibly reduced the obesity rate by 2.5 percentage points."
Dr. Sean Wharton, an internal medicine specialist who also runs a weight management and
diabetes clinic in Toronto, believes that the move is a positive one by the government,
particularly for those who are paying close attention to their nutrition. However, it's likely a
different story for the general population.
"From an overall population level, I'm not so sure it'll have the big impact that we're actually
looking for," Wharton said.
"I don't think it's going to decrease weight from a population basis, but I think an informed
consumer is better at making choices and making judgements."
Wharton also noted that data supporting the idea of health benefits from such labelling is weak.
As well, he said, no studies have found that nutrition intake is any better in a general population
when such measures are undertaken.
While the evidence may be slim for a smaller waistline associated with menu labelling, experts
believe that it's important that people make informed decisions.
"I think it's important for consumers to have choice," Belfontaine said. "I think it's important for
consumers to have the right information."

Requiring restaurants to put calorie counts on menus is an example of which mechanism of policy

A. Exhortation
B. Expenditure
C. Taxation
D. Regulation
E. Public Ownership

Dr Wharton suggests that “an informed consumer is better at making choices and making judgements.” What ethical principle does this represent?

A. Autonomy
B. Non-maleficence
C. Beneficence
D. Justice

pearferret703

PRN0098C Chapter Notes -Joint Replacement, Orthotics, Arthroplasty

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