Total Knee Arthroplasty (TKA) UNFOLDING Reasoning ALL ANSWERS 100% CORRECT SPRING FALL-2022 SOLUTION AID GRADE A+

John Roberts, 68 years old Primary Concept Infection Interrelated Concepts (In order of emphasis) • Perfusion • Tissue Integrity • Pain • Clinical Judgment • Patient Education • Communication NCLEX Client Need ...

John Roberts, 68 years old Primary Concept Infection Interrelated Concepts (In order of emphasis) • Perfusion • Tissue Integrity • Pain • Clinical Judgment • Patient Education • Communication NCLEX Client Need Categories Percentage of Items from Each Category/Subcategory Covered in Case Study Safe and Effective Care Environment • Management of Care 17-23% • Safety and Infection Control 9-15% Health Promotion and Maintenance 6-12% Psychosocial Integrity 6-12% Physiological Integrity • Basic Care and Comfort 6-12% • Pharmacological and Parenteral Therapies 12-18% • Reduction of Risk Potential 9-15%• Physiological Adaptation 11-17%UNFOLDING Reasoning History of Present Problem: John Roberts is a 68-year-old Caucasian male who is 6 feet tall (180 cm) and weighs 260 lbs. (118.2 kg) (35.3 BMI). He has a history of diabetes, hypertension, and hyperlipidemia and smokes one pack per day since the age of 18 (50 pack- years). He has osteoarthritis (OA) in his right knee and the pain has significantly increased over the past year. John had a right total knee arthroplasty (TKA) four days ago and refused to go to a rehabilitation center because of the expense and distance from his home. He decided to have physical and occupational therapy home health services. You are the home health nurse that will be caring for him, and you have arrived for his first home visit. Personal/Social History: John is a retired lumberjack who enjoys being outdoors. He has become increasingly frustrated because he is not able to do the outdoor activities he once did. He has been married for 50 years to Mary and lives in the rural Appalachian Mountains and must travel a long distance for basic medical care. What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse? RELEVANT Data from Present Problem: Clinical Significance: Diabetic Untreated diabetes, hypertension, and hyperlipidemia can lead to poor Hypertension peripheral circulation due to plaque build up. This can exacerbate Hyperlipidemia preexisting conditions like osteoarthritis because without proper blood 50 pack year smoker flow the bones and knee joint will not get the proper nutrients to heal Total knee arthroplasty 4 days ago Years of smoking also negatively affect the peripheral circulation, smokers Osteoarthritis in right knee tend to take longer to heal Osteoarthritis is deteriorative joint condition RELEVANT Data from Social History: Clinical Significance: Retired lumberjack, active lifestyle until Lumberjack is a physically demanding job, so he may have developed a recently high pain tolerance. Might have a tendency to under-report his pain. Married for 50 years Rural living—access to medical care may be limited, he may choose not Rural living seek medical help due to long commute and time it takes