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Question

Difficulty: MediumBasic Care and Comfort

A client is recovering in the orthopedic unit after undergoing a right total hip arthroplasty via a posterior approach. The client requires a fracture bedpan for elimination. Which technique should the practical nurse use to place the bedpan safely?

  1. Turn the client onto the unaffected left side while maintaining an abduction pillow between the legs, position the pan, and carefully roll the client back.Answer
  2. B
    Elevate the head of the bed to 90 degrees and instruct the client to lean forward while sliding the pan underneath the buttocks.
  3. C
    Direct the client to flex both knees firmly and press their heels into the mattress to lift the pelvis off the bed.
  4. D
    Roll the client onto the right operative side with both legs kept completely straight and together to wedge the pan into place.

Answer

The nurse should place an abduction pillow between the client's legs, turn the client onto the unaffected left side, position the fracture pan, and roll the client back onto it.
Turning the client onto the unoperated (left) side while keeping an abduction pillow between the legs ensures that the right hip remains in a neutral, abducted position. This safely allows the nurse to position the fracture pan without causing adduction, internal rotation, or extreme flexion, which are all strictly contraindicated following a posterior hip replacement.

Step-by-Step Solution

1
Identify the surgical approach and associated positioning precautions for the client.
The client had a posterior total hip arthroplasty, which requires avoiding hip flexion greater than 90 degrees, adduction (crossing the legs), and internal rotation.
Adhering strictly to joint precautions prevents the head of the femur from dislocating from the newly implanted acetabulum.
2
Select the appropriate elimination device and safe positioning technique.
A fracture bedpan is chosen because of its lower profile, and the client is logrolled onto the unaffected side using an abduction pillow.
The abduction pillow prevents the legs from crossing the midline, and rolling to the unaffected side protects the operative hip joint from dangerous rotational and pressure forces.

Key Concept

Postoperative Positioning and Joint Precautions
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Topics

Basic Care and Comfort

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