Pain, paresthesia, pulse, pallor and paralysis - The 5 Ps of neurovascular functioning

Joint replacement - A surgical procedure in which a mechanical device, designed to act as a joint, is used
to replace a diseased joint; most common joints: hip, knee, shoulder, finger; accurate fitting is essential;
excellent pain relief; infection is a post-op concern

Nursing assessment for joint replacement - Joint pathology: arthritis, fracture, pain not relieved by
medication, poor ROM

Nursing plans and interventions for joint replacement - Monitor incision site, assess for bleeding ad
drainage, assess suture line for erythema and edema, assess suction drainage apparatus, assess for signs
of infection; monitor functioning of extremity - check circulation, sensation and movement of extremity
distal to placement; I&O; 3Lfluid/day; work closely with health care team to increase client's mobility
gradually

Infection - Big problem after joint replacement

Fracture - Predispose the client to anemia, especially if long bones are involved; check HCTq3-4 days to
monitor erythropoiesis

Amputation - Surgical removal of a diseased part or organ; causes are perpherial vascular disease,
trauma, congenital deformities, malignant tumors, infection

Nursing assessment for amputation - Assess for symptoms of peripheral vascular disease: cool
extremity, absent peripheral pulses, hair loss on affected extremity, necrotic tissue or wounds, leathery
skin on affected side, decrease of pain sensation; assess for inadequate circulation: arteriogram, Doppler
flow studies

Nursing plans and interventions for amputation - Provide wound care, change dressing as needed,
maintain proper body alignment in and out of bed; position the client to relieve edema and spasms at
residual limb site: passive ROM