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Question

Difficulty: EasyReduction of Risk Potential

During the immediate postoperative period following a posterior total hip arthroplasty, the nurse plans care to maintain joint stability. Which specific action must the nurse implement to protect the new prosthesis from dislocation?

  1. Maintain an abduction wedge between the client's lower extremities.Answer
  2. B
    Elevate the head of the bed to a 90-degree angle for all meals.
  3. C
    Allow the client to cross their legs at the ankles for comfort.
  4. D
    Delegate the initial baseline neurovascular assessment to the nursing assistant.

Answer

Maintain an abduction wedge between the client's lower extremities.
Following a total hip arthroplasty with a posterior approach, the joint is highly susceptible to dislocation if it is adducted, internally rotated, or flexed beyond 90 degrees. Maintaining an abduction wedge between the legs physically prevents adduction (the legs crossing the midline), thereby reducing the risk of the prosthesis popping out of the joint socket.

Step-by-Step Solution

1
Identify the surgical procedure and its specific structural risks.
The client underwent a posterior total hip arthroplasty, which carries a high risk of posterior dislocation.
Different surgical approaches dictate specific postoperative movement restrictions.
2
Determine the contraindicated movements for a posterior approach.
The restricted movements are hip flexion greater than 90 degrees, adduction (crossing the midline), and internal rotation.
Understanding the mechanism of injury is required to select the correct preventative nursing intervention.
3
Select the nursing action that actively prevents these hazardous movements.
Placing an abduction wedge between the legs prevents adduction, directly mitigating the risk of dislocation.
This intervention aligns with the core goal of reducing risk potential in the immediate postoperative period.

Key Concept

Postoperative risk reduction for a posterior total hip arthroplasty requires strict avoidance of hip adduction, internal rotation, and severe flexion.
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Topics

Reduction of Risk Potential

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