Orthopaedic Nursing最新文献

Bone cement, a polymer material frequently used in orthopaedic joint replacement procedures, has been in use since the 1870s when prostheses were crafted from plaster and resin. The meticulous preparation of bone cement is a crucial task handled by operating room nurses to ensure patient safety. During the preparation of bone cement, an irritating and pungent vapor is exposed due to the methyl methacrylate monomer. Special vacuum mixing techniques are used to minimize exposure to this vapor, protecting both patients and medical staff during surgeries. These methods increase safety by reducing the spread of methyl methacrylate monomer vapor to the environment and contribute to the success of the surgery by ensuring that the cement is homogeneous. However, any mistakes or oversights in the application process can result in serious health issues. Given the dangers associated with breathing in or touching methyl methacrylate monomers, it is essential for operating room nurses to carry out this process correctly by strictly following safety rules. This review aims to discuss bone cement preparation methods, safety precautions, and potential challenges based on literature.

Adhesive capsulitis (AC), commonly known as frozen shoulder (FS) or arthrofibrosis, is a condition characterized by progressive stiffness, loss of motion, and pain in the shoulder joint. It is a relatively common diagnosis that often has a prolonged clinical course, significant patient morbidity, and high socioeconomic burden. The etiology involves a combination of intrinsic and extrinsic factors leading to inflammation, fibrosis, and subsequent joint capsule contracture. Although many studies have examined various treatments for this condition, there is currently no consensus on an optimized treatment algorithm. This paper synthesizes current knowledge and emerging research to provide insights into the effective management of adhesive capsulitis, emphasizing the importance of early diagnosis and individualized treatment plans.

Interruption of anticoagulation for a surgical procedure is individualized and based on balancing the risk of perioperative thromboembolism versus the risk of bleeding. Risk assessment for thromboembolism is based on the indication for anticoagulation and a variety of patient-specific factors. Bleeding risk assessment is also largely based on patient factors, such as age and comorbidities, but also the type of procedure being done. The post-operative bleeding risk of surgical procedures can be categorized as high-risk, low-to-moderate-risk, and minimal risk. Each risk category has unique recommendations regarding how long to hold anticoagulation prior to the procedure and when anticoagulation can be safely resumed. Lastly, the type of anticoagulant plays a role in the perioperative strategy based on the duration of action and onset of anticoagulation. Nurses play an important role in risk assessment, patient education, and administration and monitoring of anticoagulants in the perioperative setting.

The article aims to examine the effect of a pre-operative high-carbohydrate drink (HCD) on unilateral, primary total hip arthroplasty and total knee arthroplasty patients by measuring post-operative antiemetic medication use and length of stay in the post-anesthesia care unit (PACU). The study used a quasi-experimental cohort design using a historical control group. We compared the intervention group who consumed the pre-operative HCD, to a historical control group, 1 year prior, who did not. The intervention group had more females (62%), was more likely to have spinal anesthesia, and was less likely to receive preoperative antiemetic medications (odds ratio (OR) = 0.41; confidence interval (95% CI): 0.21, 0.79) and postoperative antiemetics (OR = 0.48; 95% CI: 0.29, 0.81). The intervention group's PACU stay was 10.1 min shorter (p < .0001) than the control group. Patients who consumed HCDs exhibited decreased PACU stay and decreased antiemetic medication use. These findings were used to change institutional preoperative policies for orthopedic patients to enhance outcomes.