Diagnosis right total knee arthroplasty Jared Griffin

Patient Introduction

Location: Orthopedic unit 0800

SBAR report from a night nurse:

Situation: Jared Griffin is a 63-year-old African American male who had a right total knee arthroplasty (TKA) yesterday morning.

Background: Mr. Griffin has a history of MRSA, which was diagnosed 3 years ago when he had surgery for a hammertoe. A nasal swab was done in the office during his recent preoperative check that came back positive for MRSA. Decolonization protocol was initiated prior to the admission for the total knee procedure and he is currently under contact precautions per hospital policy. He has a history of osteoarthritis and mild hypertension.

Assessment: Mr. Griffin is afebrile with a temp of 37.2 °C (99.8 °F), and vital signs have been stable during the night. Pain level has been at a 2–3. He has dangled his feet off the side of the bed and will have physical therapy in his room at 1000. He has been able to bend his knee to a 75-degree angle and the goal is 90 degrees. The surgeon changed Mr. Griffin’s dressing, and discontinued the drain and IV fluids, at 0700 on his morning round. His labs just came up, but I haven't had a chance to look at them yet.

Recommendation: You'll need to go in and do your morning assessment. Continue with contact precautions, and observe for signs and symptoms of infection.

Fundamentals of Nursing Care

1. Taylor, C., Lynn, P., Bartlett, J. (2019). Fundamentals of Nursing: The Art and Science of Person-Centered Care,9th Edition.
2. Asepsis and Infection Control, Chapter 24, pp. 594-637
3. Components of a Neurovascular Assessment, Chapter 26, p. 721, Box 26-7
4. Postoperative Nursing Care, Chapter 30, pp. 958-966

Diseases and Conditions

1. Expert Clinical Content from Lippincott Advisor
2. Methicillin-resistant Staphylococcus aureusMethicillin-resistant Staphylococcus aureus

Pharmacology

1. Expert Clinical Content from Lippincott Advisor
2. Clindamycin hydrochloride
3. Oxycodone hydrochloride-acetaminophen
4. Enoxaparin sodium

Diagnostics

1. Expert Clinical Content from Lippincott Advisor
2. White blood cell count and differential
3. Red blood cell count Red blood cell count
4. Hematocrit test
5. Hemoglobin level test
6. Red blood cell indices
7. Platelet count
8. Blood urea nitrogen level test

Procedures

1. Expert Clinical Content from Lippincott Procedures
2. Isolation garb, donning
3. Isolation garb, removal
4. Hand hygiene