NURSING DIAGNOSIS: Pain: knee

related to tissue trauma and reflex muscle spasms associated with the surgery, blood accumulation and edema in the surgical area, and improper positioning of the operative extremity.

Desired Outcome
The client will experience diminished knee pain (see Standardized Postoperative Care Plan, Diagnosis 6, for outcome criteria).
Nursing Actions and Selected Purposes/Rationales
  1. Refer to Standardized Postoperative Care Plan, Diagnosis 6, for measures related to assessment and reduction of pain.
  2. Implement additional measures to reduce pain:
    1. maintain operative extremity in proper alignment
    2. move the operative extremity carefully
    3. apply ice packs to the operative knee for first 24-48 hours after surgery if ordered to reduce bleeding and edema in the surgical area
    4. elevate operative leg on pillow (when not in CPM machine) for the first 48 hours after surgery in order to reduce edema in the surgical area; place pillows so knee flexion is avoided
    5. maintain patency of the wound drainage system if present to prevent accumulation of fluid in the surgical area
    6. remind client to avoid flexing operative knee beyond prescribed limits
    7. ensure that knee immobilizer is worn as prescribed in order to prevent strain on the operative area
    8. administer prescribed analgesics before exercise and ambulation sessions
    9. apply ice packs to operative knee for 20-30 minutes before and after exercise and ambulation sessions as ordered.