Examkin

Question

Difficulty: MediumBasic Care and Comfort

A client who underwent a right total hip arthroplasty (posterior approach) two days ago is unable to transfer to the bathroom and requests assistance with a bowel movement. Which action should the practical nurse take to safely assist the client with elimination?

  1. Provide a fracture bedpan and instruct the client to lift their hips using an overhead trapeze.Answer
  2. B
    Elevate the head of the bed to 90 degrees to promote a natural sitting position.
  3. C
    Logroll the client onto the right operative side to slide a standard bedpan underneath.
  4. D
    Assist the client to sit on a standard-height bedside commode placed next to the bed.

Answer

The most appropriate and safe action is to provide a fracture bedpan and instruct the client to lift their hips using an overhead trapeze.
Providing a fracture pan prevents extreme hip flexion because it is significantly flatter than a standard bedpan. Instructing the client to use an overhead trapeze allows them to lift their weight safely without twisting the spine or dislodging the hip prosthesis.

Step-by-Step Solution

1
Identify the surgical precautions for the client's specific procedure.
A posterior approach total hip arthroplasty requires avoiding hip flexion greater than 90 degrees, adduction across the midline, and internal rotation.
Adhering to these limitations prevents the head of the femur from popping out of the acetabular cup (dislocation).
2
Evaluate elimination devices based on the identified physical restrictions.
Standard bedpans and standard-height commodes require hip flexion that often exceeds 90 degrees.
The equipment used for basic care and comfort must be adapted to keep the hip joint in a safe alignment.
3
Select the intervention that facilitates elimination while maintaining joint stability.
Using a fracture pan combined with an overhead trapeze minimizes hip flexion and avoids rolling onto the operative hip.
A fracture pan's flat end slips easily under the buttocks, and the trapeze allows the client to bear weight on the upper body and unaffected leg safely.

Key Concept

Basic care adaptations for postoperative positioning precautions
Rate this question

Topics

Basic Care and Comfort

More questions from this topic