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Question

Difficulty: EasyBasic Care and Comfort

An older adult client is resting in bed following a right total hip arthroplasty (posterior approach). The nurse is reviewing the client's care plan regarding mobility and comfort. Which of the following positioning actions is appropriate for this client?

  1. Place an abductor wedge between the client's legs.Answer
  2. B
    Sit the client upright at a 90-degree angle during meals.
  3. C
    Instruct the client to cross their legs at the ankles for comfort.
  4. D
    Place a large rolled blanket directly under the surgical knee.

Answer

The appropriate positioning action is to place an abductor wedge between the client's legs.
Following a posterior total hip arthroplasty, the client's legs must remain abducted to prevent the new prosthetic joint from dislocating. An abductor wedge effectively maintains this safe alignment.

Step-by-Step Solution

1
Identify the surgical procedure and approach.
The client had a right total hip arthroplasty using a posterior approach.
Different surgical approaches have specific postoperative precautions to prevent complications.
2
Recall the positioning restrictions for a posterior hip arthroplasty.
Hip flexion greater than 90 degrees, adduction, and internal rotation must be avoided.
These movements can cause the head of the femur to pop out of the acetabulum, leading to dislocation.
3
Evaluate the given positioning options against these restrictions.
Sitting at 90 degrees causes excessive flexion. Crossing the legs causes adduction. Placing a roll under the knee risks contracture and DVT. Using an abductor wedge maintains proper alignment.
Only the abductor wedge aligns with safe postoperative care for this specific procedure.

Key Concept

Postoperative positioning and joint precautions following a posterior total hip arthroplasty.
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Topics

Basic Care and Comfort

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