NURS 6521 Management of Pain in Hip Replacement Surgery

NURS 6521 Management of Pain in Hip Replacement Surgery
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and breaking her hip on the stairs outside her home. The woman’s pain in the time since her injury has been severe, and her care team has been treating it with morphine. Which of the following administration schedules is most likely to control the patient’s pain?
NURS 6521 Management of Pain in Hip Replacement Surgery
The stem of a hip replacement is always made of metal, but
different combinations of metal, plastic or ceramic materials
are used for the ball and the socket:
• A metal ball with a plastic socket (metal-on-plastic) is the
most widely used combination.
• A ceramic ball may be used either with a plastic socket
(ceramic-on-plastic) or with a ceramic socket (ceramicon-ceramic). These combinations are often used in younger,
more active patients.
The implants also come in different shapes and sizes and your
surgeon will select the one that best matches your natural hip.
They’ll also take into account how active you hope to be in
the future. A larger diameter implant allows a greater range
of movement, so may be the best option if you expect to
take part in quite vigorous exercise.
Very occasionally, if ready-made implants aren’t right for you,
your surgeon may have one specially made.
Often, the artificial joint components are fixed into the bone with
acrylic cement, but it’s becoming more common for either one
part or both parts to be inserted without cement, especially in
more active patients. Where only one part is fixed with cement
(usually the socket) it’s known as a hybrid hip replacement.
If cement isn’t being used, the surfaces of the implants are either
roughened or else specially coated with a material made from
minerals similar to those in natural bone. This provides a good
surface for the bone to ‘grow onto’. Bone is an active, living tissue
and, as long as it’s strong and healthy, it’ll continue to renew itself
over time and provide a long-lasting bond.
Pelvis
Thigh bone
(femur)
Hip replacement surgery information booklet Page 10 of 40 Page 11 of 40
versusarthritis.org
Pre-admission clinic
Most hospitals will invite you to a pre-admission clinic, usually about
two to three weeks before the surgery. You’ll be examined and have
tests to make sure you’re generally well enough to undergo surgery.
Tests may include:
• blood tests
• x-rays of your hip
• a urine sample to rule out any infections
• an electrocardiogram (ECG) to make sure your heart is healthy.
The hospital team will probably tell you at this stage whether the
operation will go ahead as planned.
You should discuss with your surgical team whether you should
stop taking any of your medications or make any changes to the
dosage or timings before you have surgery. It’s helpful to bring your
medicines, or a list of them, along to this appointment.
Your surgeon will probably recommend muscle-strengthening
exercises to do in the weeks before the operation, as this can help
with your recovery.
If you smoke, your surgeon will suggest you try to stop as smoking
can increase the risk of complications during and after surgery
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