Knee Arthroplasty (10 Questions)

1. Mme. Chantal Bérubé, 70 years old, is postoperative day 1 following a right total knee arthroplasty for severe osteoarthritis. Medical orders include neurovascular checks q4h, pain management PRN, and early mobilization with physiotherapy. During assessment, the nurse notes increased pain not relieved by analgesia, decreased sensation in the toes, and pallor of the operative foot. Pedal pulses are weaker compared to earlier.

Question:
What is the priority nursing action? *
2. Mr. Luc Desrochers, 68 years old, is postoperative day 1 following a left total knee arthroplasty. Orders include use of a CPM machine for 6 hours daily. The patient states the device is uncomfortable and asks if he can stop using it. Pain is controlled with prescribed analgesia.

Question:
What explanation should the nurse provide? *
3. Mme. Louise Caron, 74 years old, is postoperative day 2 following a right total knee arthroplasty. The nurse observes a pillow placed directly under the patient’s knee, keeping it in a flexed position for several hours. The patient states it helps relieve pain.

Question:
What is the most appropriate nursing intervention? *
4. Mr. André Lemaire, 72 years old, is postoperative day 1 following a right total knee arthroplasty for severe osteoarthritis. He is scheduled for physiotherapy 30 minutes after breakfast. His current medical orders include:
*Acetaminophen 1,000 mg PO q6h scheduled (last dose given at 06:00)
*Hydromorphone 0.5 mg IV q3h PRN for severe pain (7–10/10)
*Ice therapy to operative knee PRN
*Weight bearing as tolerated with walker
*Vital signs q4h

At 08:00, Mr. Lemaire reports pain rated 7/10 at the operative knee. He appears tense and states he is unsure he can participate in physiotherapy because of the pain. Vital signs are stable.

Question:
What is the most appropriate nursing action? *
5. Mme. Sylvie Dufour, 76 years old, is postoperative day 3 following a total knee arthroplasty. Orders include elastic compression stockings, anticoagulant therapy, and ambulation. She asks why the stockings are necessary since she is already walking.

Question:
What is the primary purpose of elastic stockings? *
6. Mr. Pierre Gagnon, 69 years old, is postoperative day 5 following a right total knee arthroplasty. The nurse notes increased warmth, redness, and swelling around the incision, with serous drainage. The patient reports fever and increasing pain.

Question:
What is the priority nursing action? *
7. Mme. Hélène Renaud, 73 years old, is postoperative day 1 following a left total knee arthroplasty. She ambulates with a walker but places minimal weight on the operative leg despite orders for weight bearing as tolerated.

Question:
What instruction should the nurse reinforce? *
8. Mr. Denis Poirier, 71 years old, is postoperative day 2 following a total knee arthroplasty and is receiving enoxaparin (Lovenox) 40 mg SC daily. The nurse notes bruising at injection sites and mild gum bleeding during oral care.

Question:
What should the nurse prioritize monitoring? *
9. Mme. Danielle Fortier, 67 years old, is preparing for discharge 6 days after a total knee arthroplasty. She will receive home physiotherapy. She asks which activity is most important to continue at home.

Question:
What should the nurse emphasize? *
10. Mr. Robert Martel, 75 years old, is postoperative day 4 following a total knee arthroplasty. He reports calf tenderness and swelling in the operative leg. The area is warm to touch.

Question:
What is the priority nursing action? *