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Improving Orthopedic-Related Postoperative Edema Management in a Rehabilitative Nursing Setting

Rehabilitation Nursing Journal: May/June 2019 - Volume 44 - Issue 3 - p E7
doi: 10.1097/RNJ.0000000000000228
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Back to Top | Article Outline


Purpose: To present a quality improvement project implemented to help reduce postoperative edema in total knee and hip arthroplasty rehabilitation patients.

Learning Objectives/Outcomes: After completing this continuing education activity, you should be able to:

1. Recall the research data applicable to postoperative edema in total knee and hip arthroplasty rehabilitation patients.

2. Summarize the results of the study of the effectiveness of an education-based quality improvement project for reducing edema following knee and hip arthroplasty.

3. Specify the clinical implications and conclusions of the study.

  1. Postoperative swelling is common after total hip arthroplasty (THA), especially in the
    1. lower back.
    2. buttocks.
    3. thigh.
  2. Brock et al. (2015) reported that vascular injury and intra-articular bleeding in the surrounding joint tissues postoperatively contribute to
    1. surgical wound dehiscence.
    2. patient noncompliance.
    3. atelectasis.
  3. Simon (2014) reported that postoperative patients’ pain and tightness due to wearing compression stockings can be managed by
    1. removing the stockings while ambulating.
    2. applying the stockings before getting out of bed in the morning.
    3. elevating both legs after removing the stockings.
  4. Results of this study showed a post-education increase of more than 20% in test answer scores related to questions about
    1. compression stocking application.
    2. edema measurement.
    3. limb elevation.
  5. One of the content areas that showed no improvement in the post-education group was
    1. medication side effects.
    2. diuretic indications.
    3. medical causes.
  6. After receiving edema education, 37% of the 24 participating patients were able to name how many characteristics of edema or methods to manage edema?
    1. two
    2. three
    3. four
  7. In terms of edema management, the authors found a statistically significant decrease in the post-education group in
    1. mild edema.
    2. documentation of ice.
    3. documentation of elevation.
  8. Average post-education scores were still less than 50% in which of the following areas?
    1. pillow placement
    2. edema measurement
    3. signs of pulmonary embolism
  9. The authors suggested that the reason a significant percentage of the patients was not sufficiently knowledgeable about edema post-education was the post-education group had a higher prevalence of
    1. obesity.
    2. dementia.
    3. depression.
  10. The authors suggested that future quality improvement work in this area could benefit from assessing patients’
    1. stress levels.
    2. health literacy.
    3. psychological readiness.
© 2019 Association of Rehabilitation Nurses.