Annotated Case Study Nursing Care Plan

Patient care for the RN requires a holistic view of the patient. Although Mr Brown is admitted for knee replacement surgery, the nursing care will also take into consideration, Mr Brown’s co-morbidites and the impact of these on his recovery following surgery. Elderly patient’s with COPD have a higher mortality rate, this can be related to the medications used in anesthetics and the effect on the pulmonary system (Gruber & Tschernko., 2015). Medications used through the surgery may impact on the lungs by altering how the patient breathes and what muscles they are using to breath. If the patient is on a mechanical breathing device, there is a high chance of altered gas exchange through the alveoli and a risk of a collapsed lung or partial collapse

(Gruber & Tschernko., 2015). The effects of these medications continue post surgery, therefore monitoring of the respiratory system and pain management will be a high priority for the RN. The RN will closely observe the respiratory system, to prevent infections such pneumonia or respiratory failure occuring for Mr Brown. This can be achieved by nursing interventions such as positioning the patient in the high fowlwers position. This will allow the lungs to have the potential to fully expand, rather than have the patient in the supine position where the lungs fall slightly to the back making the body work harder to breathe. Also, encouraging deep breathing exercises and coughing will aid in restoring or maintaining the patient’s breathing capabilities.