A practical nurse is planning morning hygiene and comfort care for a client who is 1 day postoperative following a right-sided total hip arthroplasty (posterior approach). The client reports mild joint stiffness and requests assistance with a bed bath and repositioning. Which action should the nurse take?
- AElevate the head of the bed to a 90-degree angle so the client can comfortably and independently wash their upper body
- Place an abduction wedge between the client's legs and obtain assistance to turn the client onto the unaffected left sideAnswer
- CAccept delegation from the registered nurse to administer the client's prescribed intravenous push (IVP) opioid analgesic prior to bathing
- DReassure the client by stating, "Don't worry about the stiffness; you will be walking perfectly and completely pain-free by tomorrow."
Answer
Place an abduction wedge between the client's legs and obtain assistance to turn the client onto the unaffected left side.
Following a total hip arthroplasty with a posterior approach, the client is at high risk for hip dislocation. To prevent this, the nurse must maintain the affected leg in a neutral, abducted position and strictly avoid hip adduction, internal rotation, and flexion greater than 90 degrees. Placing an abduction wedge between the legs prevents adduction, and turning the client onto the unaffected (left) side while maintaining alignment is the safest way to provide back care and reposition the client for comfort.
Step-by-Step Solution
Key Concept
Postoperative Positioning and Safety in Total Hip Arthroplasty