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Difficulty: MediumBasic Care and Comfort

A client is recovering on the surgical unit the day after undergoing a right posterolateral total hip arthroplasty. The practical nurse is preparing to cleanse the client's back and sacral area. Which action should the nurse take to maintain proper joint alignment and prevent dislocation?

  1. A
    Keep the client's legs close together in adduction while rolling them onto the operative side.
  2. B
    Elevate the head of the bed to a 90-degree angle and have the client lean forward.
  3. Place an abductor pillow between the client's legs and turn them onto the non-operative side.Answer
  4. D
    Ask the client to bend the right knee and push down with the heel to lift the buttocks.

Answer

Place an abductor pillow between the client's legs and turn them onto the non-operative side.
Following a posterolateral total hip arthroplasty, the client is at high risk for hip dislocation if the hip is flexed past 90 degrees, adducted, or internally rotated. Placing an abductor pillow between the legs maintains continuous abduction and proper alignment while safely turning the client onto their non-operative side.

Step-by-Step Solution

1
Identify the surgical approach and its specific precautions.
The client had a posterolateral total hip arthroplasty, which requires avoiding hip flexion greater than 90 degrees, adduction, and internal rotation.
These specific movements can cause the head of the femur to pop out of the acetabular cup.
2
Evaluate the safest positioning method for providing back care.
Turning the client safely requires keeping the legs apart to maintain alignment.
An abductor pillow securely maintains the legs in abduction, preventing the operative leg from crossing the body's midline.
3
Select the correct turning action.
The nurse places the abductor pillow and turns the client to the non-operative side.
This complies with all hip precautions while allowing necessary access to the sacral area.

Key Concept

Postoperative Positioning for Total Hip Arthroplasty
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Topics

Basic Care and Comfort

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