numbness and tingling post hip/knee surgery?

[Btts]

I wanted to know what numbness and tingling after hip or knee surgey implies. what are the nursing are the nursing implementation when a pt reorts this to you. i just started on an ortho floor. I remember in nsg sch u were suppose to check for numbness and tingling but i don't remember the pathopysiology. Thanks ...

[Btts]

Can you hlep me answer this question pleasea?

[dianah, ASN]

Moved to General Nursing Discussion area.

[goodstudentnowRN]

This could be tarsal tunnel syndrome..Sometimes surgery is the best option for treating tarsal tunnel syndrome. The foot and ankle surgeon will determine if surgery is necessary and will select the appropriate procedure or procedures based on the cause of the condition.

The interventions are as follows:

Rest. Staying off the foot prevents further injury and encourages healing.

Ice. Apply an ice pack to the affected area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again. Oral medications. As prescribed; Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.

Immobilization. Restricting movement of the foot by wearing a cast is sometimes necessary to enable the nerve and surrounding tissue to heal.

Physical therapy. Ultrasound therapy, exercises, and other physical therapy modalities may be prescribed to reduce symptoms.

Injection therapy. Injections of a local anesthetic provide pain relief, and an injected corticosteroid may be useful in treating the inflammation.

Orthotic devices. Custom shoe inserts may be prescribed to help maintain the arch and limit excessive motion that can cause compression of the nerve.

Shoes. Supportive shoes may be recommended.

Bracing. Patients with flatfoot or those with severe symptoms and nerve damage may be fitted with a brace to reduce the amount of pressure on the foot.

[rn/writer, RN]

Numbness and tingling could indicate some kind of nerve compression, possibly due to post-op swelling. Assess the level at which the n/t begin, whether the patient can feel your touch, if the patient can feel below the numb area, if they can feel/move their toes, etc.

As you are new to the floor, you might want to ask more experienced nurses or your charge nurse if this is a normal consequence of this type of surgery that will abate with time or something out of the ordinary. Depending on how recent the surgery was, it might also related to the type of anesthetic used. For example, c-section patients are often numb and tingling below the waist following an epidural. The only time we would report this to a doc is if it didn't wear off in a reasonable amount of time.

I'd say your best bet is to do a good assessment and confer with the experienced nurses on your floor.

Let us know what happens.

[diane227, LPN, RN]

You don't indicate the time period in which these symptoms are appearing. How far out is this patient in the post operative period? Did the patient have any type of block? Did the patient have an epidural or a intrathecal?

[Btts]

Thanks to all ur answer. To add to the to the question. This is a patient with no epidural. N/T after post op day 2 0r 3. What if is post op day 1 with these c/o. Usually with total hip, Total knee, PLIF anf kyphoplasty.

[LouisVRN, RN]

I work on an ortho floor, whenever my patient complains of numbness and tingling my questions to ask are: Is this something different from you baseline? (A lot of patients have some form of neuropathy which causes numbness/tingling all the time, especially if they were off their meds while NPO prior to surgery) What kind of anesthesia did you have? (Having a spinal/epidural/block or sometimes even the pain pumps can cause numbness and tingling when this wears off) Is this something new? Is it getting worse/better? Is there anything you can do that makes it better/worse)? Check capillary refill, especially if the patient has a dressing on (It always COULD be compartment syndrome, if so this is what you are thinking make sure the doctor orders CPK labwork) Check sensorium can they feel a light touch? Heavy pressure? How swollen is the extremity, is it raised above the heart if possible (Obviously not going to happen with a femur fracture) Have they done more activity today than normal? Is it in the post-op extremity (If it is in the other extremity my main concern would be a possible DVT if they had not been on prophylaxis and had not been moving much). If you cant think of a possible cause and often times even when you can, this warants a doctors call, even at 2am. You want to make sure you tell them everything you found in your assessment. I hope this helps.