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Difficulty: EasyReduction of Risk Potential

Following a right total hip arthroplasty, a nurse is establishing a plan of care to minimize potential postoperative complications. Which of the following interventions should be included? (Select all that apply.)

  1. Maintain the operative leg in an abducted position while the client is resting in bed.Answer
  2. Place an abduction wedge between the client's legs when turning them to the unaffected side.Answer
  3. C
    Position the client so the hips are flexed at a 110110-degree angle when sitting in a bedside chair.
  4. Instruct the client to avoid crossing their legs at the knees or ankles during recovery.Answer
  5. E
    Delegate the initial assessment of the surgical incision to an unlicensed assistive personnel (UAP).
  6. Apply the prescribed sequential compression devices (SCDs) to the bilateral lower extremities.Answer

Answer

The correct interventions to reduce postoperative complications are maintaining the leg in abduction, using an abduction wedge when turning, avoiding crossing the legs, and applying sequential compression devices.
To minimize postoperative complications following a total hip arthroplasty, the primary goals are preventing prosthesis dislocation and ensuring adequate venous return. Maintaining the operative leg in an abducted position, utilizing an abduction wedge during turns, and instructing the client not to cross their legs all effectively prevent hip adduction, a major cause of dislocation. Furthermore, applying sequential compression devices (SCDs) is a standard, evidence-based intervention that promotes blood flow and significantly reduces the risk of deep vein thrombosis.

Step-by-Step Solution

1
Identify the primary risks following a total hip arthroplasty.
The most common and severe complications include prosthesis dislocation, deep vein thrombosis (DVT), and surgical site issues like bleeding or infection.
Recognizing specific postoperative risks guides the selection of targeted, safe interventions.
2
Evaluate interventions related to client positioning.
Abducting the leg, using a wedge during turns, and avoiding crossing the legs correctly prevent adduction and dislocation. Flexing the hip to 110110 degrees is incorrect because flexion must remain below 9090 degrees.
Maintaining proper joint alignment is critical to preserving the integrity of the new hip prosthesis.
3
Evaluate interventions related to circulation and delegation.
Applying sequential compression devices safely reduces DVT risk. Delegating the initial wound assessment to a UAP is unsafe and outside their scope of practice.
Delegation rules require the RN to perform all initial assessments, and mechanical prophylaxis is a standard of care for DVT prevention.

Key Concept

Postoperative risk reduction and hip precautions following total hip arthroplasty.
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Topics

Reduction of Risk Potential

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