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Mrs Grace Potter is a 67- year old woman who presented with rheumatoid arthritis of the right hip.

Mrs Grace Potter is a 67- year old woman who presented with rheumatoid arthritis of the right hip. She has been a client of her local General Practitioner and has been medically managing her pain for the past 8 months. Due to worsening pain and decreasing mobility, Grace was referred to a surgical specialist and requires a total hip replacement (THR). Grace has a history of hypertension, hyperlipidaemia and poorly managed Type 2 Diabetes requiring oral hypoglycaemics. Grace is widowed and lives alone, but has a son who lives nearby and is in regular contact. Grace lives in her own home, which has six steps at the front, and is usually able to her own activities of daily living (ADLs) and household work independently. Recently Grace has been having difficulty with her ADLs and with general mobility due to pain in her leg. Grace has just returned to the orthopaedic ward post total hip replacement (THR) surgery. She has IV Normal Saline 0.9% running. She is drowsy but rousable and is complaining of pain (rating 7/10). Her vital signs on arrival to the ward are: BP 145/70, HR 105bpm, temp 35.9 degrees, SpO2 99% on 8 litres of oxygen via a Hudson mask. She has a dressing on her right hip that is intact, but there is a small amount of blood oozing out. She has a Redi-vac drain in situ that contains 50 mLs of frank coloured blood. She also has patient-controlled analgesia (PCA) in situ. A Charnley pillow (foam abduction pillow) is used. You have been 

1. Discuss the risk factors and pathophysiology of the chosen health concern for Mrs Potter 2. List and discuss four (4) components of an initial post-operative assessment you (RN) would undertake for Mrs Potter. Provide a rationale for each assessment relating to Mrs Potter's conditions and justify with evidence-based literature. 3. Identify TWO (2) priorities of nursing care to meet Mrs Potter's needs identified in your initial post-op assessment. Also provide a rationale for why these are a priority. One nursing care priority to be discussed must be DVT. Provide a comprehensive care plan to address the identified TWO (2) nursing care priorities. Use evidence-based literature to justify why each intervention is likely to be appropriate for Mrs Potter. 5. Use Gibb's Reflective Cycle as a framework to demonstrate how you would reflect on the process of managing the chosen post-op potential health concern and what you have learnt from designing the plan. This section can be written in first person.

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