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Difficulty: MediumBasic Care and Comfort

A practical nurse is assisting with the care of a client who is 1 day postoperative following a right total knee arthroplasty. The client reports discomfort in the right leg and asks the nurse to place a pillow directly under their right knee for support. Which of the following is the most appropriate nursing action?

  1. Elevate the right leg by placing a pillow under the lower calf and ankle, keeping the knee straight.Answer
  2. B
    Place a soft pillow directly under the client's right knee as requested to provide immediate comfort.
  3. C
    Place a rolled towel under the right thigh and a small pillow under the knee to maintain joint flexion.
  4. D
    Keep the entire right leg flat on the mattress without any pillows to prevent dependent edema.

Answer

Elevate the operative leg by placing a pillow under the lower calf and ankle, ensuring the knee itself remains unsupported and fully extended.
Following a total knee arthroplasty, it is critical to maintain the operative knee in full extension during periods of rest to prevent a flexion contracture. Elevating the leg by placing a pillow under the lower calf and ankle allows for venous return and reduction of postoperative edema while ensuring the knee joint remains straight, properly aligned, and unsupported.

Step-by-Step Solution

1
Evaluate the client's request for a pillow directly under the operative knee.
Recognize that fulfilling this request would place the knee in a flexed position.
Knee flexion must be avoided during rest periods after a total knee arthroplasty to prevent the development of a flexion contracture.
2
Determine the optimal positioning intervention that addresses both discomfort and postoperative swelling.
Select a positioning strategy that elevates the limb without bending the joint.
Placing a pillow under the lower calf and ankle achieves leg elevation to reduce dependent edema while keeping the knee straight and properly aligned.

Key Concept

Postoperative Positioning and Contracture Prevention
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Topics

Basic Care and Comfort

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