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Lesechka [4]
3 years ago
14

Richard is a 72-year-old veteran with a history of end-stage bilateral knee osteoarthritis. He underwent right total knee arthro

plasty (TKA) 3 days ago. He is currently taking oxycodone 5 mg with ibuprofen 800 mg three times daily for moderate post-op pain. He has a history of major depression that includes high levels of anxiety symptoms (anxious depression) which is treated with citalopram 20 mg daily and quetiapine 300 mg daily.
Which of the following is a risk factor for chronic persistent postsurgical knee pain in Richard?a. His ageb. His male genderc. His history of anxious depressiond. His continued use of oxycodone on postoperative day 3
Health
1 answer:
Ostrovityanka [42]3 years ago
5 0

c. His history of anxious depression

Explanation:

Medical comorbidities like anxiety and depression pre and postoperatively will lead to suboptimal or poor functional outcomes after total knee arthroplasty.  

Anxiety can increase the blood pressure which can lead to many postoperative complications after a TKA which in turn can result in poor outcomes from the surgery resulting in chronic pain.

A depressed patient will have a poor motivation to perform rehabilitative therapies in the postoperative period after TKA which are very vital for successful functional outcome of the operated knee. This also will lead to chronic persistent post-surgical knee pain.

Depression leads to dissatisfaction in the result after TKA which will make them feel pain.

Many studies have proved that anxiety and depressing will only lead to chronic pain syndrome among the elderly.

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Use the drop-down menus to complete each sentence.
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Answer:

The body takes nutrients from food and converts them to energy. After the body has taken the food components that it needs, waste products are left behind in the bowel and in the blood.

The kidney and urinary systems help the body to eliminate liquid waste called urea, and to keep chemicals, such as potassium and sodium, and water in balance. Urea is produced when foods containing protein, such as meat, poultry, and certain vegetables, are broken down in the body. Urea is carried in the bloodstream to the kidneys, where it is removed along with water and other wastes in the form of urine.

kidney diagram

Other important functions of the kidneys include blood pressure regulation and the production of erythropoietin, which controls red blood cell production in the bone marrow. Kidneys also regulate the acid-base balance and conserve fluids.

Kidney and urinary system parts and their functions

Two kidneys. This pair of purplish-brown organs is located below the ribs toward the middle of the back. Their function is to:

Remove waste products and drugs from the body

Balance the body's fluids

Release hormones to regulate blood pressure

Control production of red blood cells

Diagram of the bladder

The kidneys remove urea from the blood through tiny filtering units called nephrons. Each nephron consists of a ball formed of small blood capillaries, called a glomerulus, and a small tube called a renal tubule. Urea, together with water and other waste substances, forms the urine as it passes through the nephrons and down the renal tubules of the kidney.

Two ureters. These narrow tubes carry urine from the kidneys to the bladder. Muscles in the ureter walls continually tighten and relax forcing urine downward, away from the kidneys. If urine backs up, or is allowed to stand still, a kidney infection can develop. About every 10 to 15 seconds, small amounts of urine are emptied into the bladder from the ureters.

Bladder. This triangle-shaped, hollow organ is located in the lower abdomen. It is held in place by ligaments that are attached to other organs and the pelvic bones. The bladder's walls relax and expand to store urine, and contract and flatten to empty urine through the urethra. The typical healthy adult bladder can store up to two cups of urine for two to five hours.

Upon examination, specific "landmarks" are used to describe the location of any irregularities in the bladder. These are:

Trigone: a triangle-shaped region near the junction of the urethra and the bladder

Right and left lateral walls: walls on either side of the trigone

Posterior wall: back wall

Dome: roof of the bladder

Diagram of the bladder layers

Two sphincter muscles. These circular muscles help keep urine from leaking by closing tightly like a rubber band around the opening of the bladder.

Nerves in the bladder. The nerves alert a person when it is time to urinate, or empty the bladder.

Urethra. This tube allows urine to pass outside the body. The brain signals the bladder muscles to tighten, which squeezes urine out of the bladder. At the same time, the brain signals the sphincter muscles to relax to let urine exit the bladder through the urethra. When all the signals occur in the correct order, normal urination occurs.

Facts about urine

Normal, healthy urine is a pale straw or transparent yellow color.

Darker yellow or honey colored urine means you need more water.

A darker, brownish color may indicate a liver problem or severe dehydration.

Pinkish or red urine may mean blood in the urine.

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