CE Connection
doi: 10.1097/01.NME.0000720284.10689.b2
- Free
GENERAL PURPOSE: To gain knowledge about conditions that lead to the need for a TKR,
complications associated with this procedure, and the appropriate preoperative and postoperative care for patients undergoing TKR surgery. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing-education activity, you should be able to: 1. Describe the anatomy and physiology of the knee and conditions associated with the need for a TKR.
2. Summarize appropriate nursing care for patients who undergo TKR surgery, including identification of potential complications and preoperative and postoperative care.
- Which type of joint is the knee?
- cartilaginous
- fibrous
- synovial
- Which part of the knee joint is enclosed in the tendon of the quadriceps femoris?
- fibula
- patella
- tibia
- Which component of the knee is lined with a synovial membrane that secretes fluid, providing lubrication and preventing friction with movement?
- joint capsule
- ligaments
- menisci
- The most common cause of chronic knee pain is
- arthritis.
- overuse syndrome.
- sports injury.
- Patients with OA typically have joint pain and stiffness that
- decrease with activity and increase with rest.
- increase with activity and decrease with rest.
- remain constant during both activity and rest.
- When evaluating the knee pain of patients with RA, the assessment findings may include
- redness and swelling.
- unilateral joint pain and stiffness.
- pain during activity and no pain with rest.
- Which best describes the goal of a TKR?
- reduce joint inflammation
- prevent cartilage deterioration
- restore function and reduce pain
- Indications for a TKR include
- acute knee inflammation and swelling.
- moderate pain and stiffness with activity.
- moderate-to-severe pain when at rest.
- When a TKR is completed, which parts of the knee joint are replaced?
- the entire patella
- the lower end of the tibia and top of the femur
- the top of the tibia and lower end of the femur
- Which is an important step in the preoperative care of the patient undergoing a TKR?
- preoperative allogenic blood transfusion
- preoperative education
- preoperative mobility exercises
- Which best describes the action that should be taken if bleeding is observed on the surgical dressing of a patient who has undergone a TKR?
- change the dressing immediately
- circle the area with a pen, then date and time it
- reinforce the dressing with sterile gauze
- While changing the dressing of a patient who has undergone a TKR, redness, edema, and warmth are observed, which indicate
- infection.
- normal healing.
- wound dehiscence.
- Which lab finding may suggest bleeding in patients who have undergone a TKR?
- increased platelet count
- increased white blood cell count
- decreased hemoglobin and hematocrit
- When checking the neurovascular status of a patient who has undergone a TKR, the mnemonic CMST can be used, with the “C” standing for
- color.
- coolness.
- complications.
- When the patient who has undergone a TKR is resting in bed, the nurse should encourage him or her to keep the operative leg
- bent, with a pillow placed directly under the knee.
- straight, with a pillow placed directly under the knee.
- straight, with a pillow placed under the leg, but not directly under the knee.
- Which is a complication associated with TKR?
- blood clots
- hypoglycemia
- pulmonary edema
- To help prevent infection in the patient undergoing a TKR, which I.V. antibiotic regimen is typically used?
- start within 1 hour of surgery; discontinue 24 hours after surgery
- start within 2 hours of surgery; discontinue 48 hours after surgery
- start within 4 hours of surgery; discontinue 12 hours after surgery
- Which patient is most at risk for a prosthetic joint infection following TKR?
- Patient A who has OA
- Patient B who needed a blood transfusion
- Patient C who starts physical therapy shortly after surgery
- If a patient who has undergone a TKR has an indwelling urinary catheter, it should be removed within
- 2 days.
- 3 days.
- 4 days.
- Along with increasing the risk of infection, prolonged wound drainage following TKR can
- cause hyperglycemia.
- delay wound healing.
- increase the need for oxygen therapy.