Patient Name: Mr. George Savary

Admission Diagnosis:

Left knee arthroplasty

Medical History:

Mr. Savary is a 56-year-old patient with a history of osteoarthritis in his knees bilaterally related

to his 20-year employment as a carpet layer. Both knees have significant erosion of the articular

cartilage, including bone erosion of the distal end of the femur and the proximal end of the tibia.

Mr. Savary experiences constant pain in his left knee. His underwent a right knee arthroplasty

one year ago. His right knee has healed successfully and he no longer experiences pain in this

leg. He is looking forward to having the left knee repaired as well and anticipates many years of

being pain free.

In addition to his osteoarthritis, George has a hx of hypertension and CAD. His hypertension is

well controlled with medication and his last checkup with the cardiologist was good with no new

concerns. He continues to take a statin to control his cholesterol.

Allergies:

Clindamycin – urticaria, pruritus

Social History:

George is divorced. He has 3 grown children and one 2-year-old grandson. He is currently on

WCB but hopes to go back to school and train for something different after his surgery. He

realizes he can no longer do his job of being a carpet layer.

George drinks beer on the weekend and smokes the occasional cigar. He uses recreational

marijuana every evening and he finds it helps with his pain. George is 185 em tall and weighs

112 kg. His pain does not allow him to walk much but he began swimming 3 times a week after

his last knee replacement.

I need DARP and focus assessment

ANSWER

DARP Assessment for Mr. George Savary

Data (D)

1. Demographics:
Mr. George Savary
56 years old
Divorced
Father of 3 grown children
2-year-old grandson
Height: 185 cm
Weight: 112 kg

2. Medical History:
Left knee arthroplasty required due to osteoarthritis from a career as a carpet layer.
History of osteoarthritis in both knees.
Right knee arthroplasty one year ago.
Well-controlled hypertension.
History of CAD; last cardiologist checkup was good.
Takes medication for hypertension and statin for cholesterol control.

3. Allergies:
Allergic to Clindamycin (resulting in urticaria and pruritus).

4. Social History:
Divorced.
3 grown children.
2-year-old grandson.
Currently on Workers’ Compensation (WCB).
Considering a career change due to the physical demands of carpet laying.
Weekend beer consumption.
Occasional cigar use.
Regular recreational marijuana use in the evening for pain relief.
Engages in swimming 3 times a week due to limited mobility from pain.

Assessment (A)

Mr. George Savary presents with a complex medical history, including osteoarthritis in both knees, with the need for left knee arthroplasty following a successful right knee replacement. He has a history of well-controlled hypertension and CAD, managed with medication. George is allergic to Clindamycin.

His social history reveals personal challenges, including divorce and career change considerations. He consumes alcohol on weekends and occasionally smokes cigars. Notably, he uses recreational marijuana to alleviate his pain, which affects his mobility. However, he has initiated swimming as an alternative exercise.

Response (R)

1. Pain Management: Addressing Mr. Savary’s pain is a priority. Assess the effectiveness of his current pain management strategies, including recreational marijuana and swimming. Discuss alternative pain management options and the potential impact on his daily life.

2. Cardiovascular Health: Considering his CAD history, collaborate with the cardiologist to ensure George’s cardiovascular health is optimized before surgery. Assess and confirm his medication regimen for hypertension and cholesterol control.

3. Allergy Management: Ensure that Clindamycin is not included in any medications prescribed during his arthroplasty.

4. Smoking and Alcohol Use: Discuss the health risks associated with smoking and weekend alcohol consumption, especially in the context of his upcoming surgery. Provide resources and support for smoking cessation if needed.

5. Career Transition: Explore George’s career change aspirations and provide guidance or referrals to vocational rehabilitation services to help him achieve his goals post-surgery.

6. Exercise Routine: Continue to encourage and monitor his swimming routine as it contributes positively to his physical well-being.

7. Family and Social Support: Assess the availability of a support system, including his grown children and grandson, to aid in his recovery and post-surgery care.

Plan (P)

1. Collaborate with the orthopedic surgeon to schedule and prepare for the left knee arthroplasty, ensuring the procedure is optimized considering George’s medical history.

2. Involve a pain management specialist to assess and possibly adjust his pain management plan. Consider non-pharmacological pain relief options.

3. Consult with a cardiologist to ensure George’s cardiovascular health is stable before surgery.

4. Educate George on the risks of smoking and alcohol consumption in the perioperative period and offer support for cessation if desired.

5. Verify that all medications prescribed during the surgery and recovery period are free of Clindamycin.

6. Explore career transition options with vocational rehabilitation services and provide guidance on pursuing a new career path.

7. Encourage and monitor his swimming routine and explore other low-impact exercises for his long-term health.

8. Assess the availability of family and social support to aid in his recovery and adjust the plan accordingly.

This DARP assessment is designed to provide a comprehensive plan for Mr. George Savary’s upcoming knee arthroplasty, considering his medical history, lifestyle, and individual needs. It aims to ensure a safe and successful surgical outcome while addressing his overall well-being.