what you are asking for is a textbook! here is a list of the basic problems that any surgical patient is likely to develop, assuming that your orthopedic patient has undergone some type of surgical intervention:
- breathing problems (atelectasis, hypoxia, pneumonia, pulmonary embolism) hypotension ( due to shock, hemorrhage)
- thrombophlebitis in the lower extremity
- elevated or depressed temperature
- any number of problems with the incision/wound (dehiscence, evisceration, infection)
- fluid and electrolyte imbalances
- urinary retention
- surgical pain
- nausea/vomiting (due to paralytic ileus)
nursing interventions, in general, take four forms: (1) assessment, monitoring, evaluating and observing the patient's condition, (2) caring, performing, providing, and assisting with actual patient care, (3) teaching, education, instructing and supervising the patient and/or the caregiver, and finally (4) managing, referring, contacting, notifying others if necessary on behalf of the patient or caregiver. to determine your orthopedic patient's problems you must perform an assessment and gather data about them. what has happened to the patient? what are his/her needs? what are his/her problems relating to the orthopedic disease or condition? only then, can you begin to develop some more specific nursing interventions.
my suggestion would be for you to look at some of the major orthopedic disorders and injuries such as fractures, osteoarthritis, gout, herniated vertebral discs, osteomyelitis, and osteoporosis and list the signs and symptoms of each of these disorders. see if you can see some similarities in the symptoms. for example, is pain a symptom that is present in many of them? if so, then nursing interventions for pain will need to be included on your list of general orthopedic interventions. is immobility another problem that seems to be common? what are some of the nursing interventions for immobility that you can think of?
think about a patient that has a broken arm. they will have the following signs and symptoms:
- sudden acute pain in the arm
- shortening and deformity of the arm
- muscle spasms of the muscles surrounding the break
- impaired sensation distal to the fracture
- limited range of motion of the limb
your nursing interventions are all aimed at those six symptoms. normally, you would develop nursing diagnoses. nursing diagnoses are groupings of symptoms with a nursing diagnostic label placed upon them. interventions are still developed for the actual symptoms. so, some of the interventions for this fractured arm would be (note how they link back to the symptoms):
- evaluate pain using a 0 to 10 numerical pain rating scale.
- administer analgesics as ordered (this is a collaborative intervention and depends on a physician order)
- assess movement and sensation of hand and fingers distal to the break every 4 hours
- remove jewelry from affected limb
- elevate the arm
- instruct patient to move the finger of the affected hand two to four times and hour
- monitor for diminished or absent radial pulse, numbness or tingling in the arm, hand or fingers, pallor, blanching, cyanosis or coolness to touch
- monitor for the inability or change in the ability to move the fingers of the affected hand
all this information should give you enough to start this assignment.
welcome to allnurses!