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Question

Difficulty: EasyReduction of Risk Potential

Following a right-sided total hip arthroplasty using a posterior approach, a client arrives at the postoperative surgical unit. Which positioning intervention should the nurse implement to minimize the risk of joint dislocation?

  1. Securing an abduction pillow between the client's lower extremities.Answer
  2. B
    Elevating the head of the bed to a 90-degree angle during meals.
  3. C
    Allowing the client to cross their ankles while resting in the supine position.
  4. D
    Positioning a pillow directly under the client's right knee to reduce swelling.

Answer

Securing an abduction pillow between the client's lower extremities.
After a posterior total hip arthroplasty, it is critical to prevent hip adduction, internal rotation, and flexion greater than 90 degrees. Securing an abduction pillow between the legs ensures the hips remain slightly separated (abducted) and prevents the client from inadvertently crossing their legs or midline, thereby substantially reducing the risk of joint dislocation.

Step-by-Step Solution

1
Identify the surgical procedure and its associated risks.
The client had a total hip arthroplasty via a posterior approach, which carries a high risk of posterior dislocation if standard hip precautions are not followed.
Understanding the specific surgical approach dictates which physical movements must be restricted to protect the new joint.
2
Determine the contraindicated movements for a posterior hip replacement.
Hip flexion greater than 90 degrees, adduction across the midline, and internal rotation are contraindicated.
These specific movements put outward pressure on the posterior joint capsule, potentially dislocating the newly placed prosthesis.
3
Evaluate the given positioning interventions against the required precautions.
Using an abduction pillow prevents adduction. Elevating the head to 90 degrees causes excessive flexion. Crossing ankles causes adduction. A pillow under the knee causes flexion and venous stasis.
Matching each nursing action to the physiological constraints isolates the correct risk reduction strategy.

Key Concept

Postoperative Hip Precautions (Posterior Approach)
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Topics

Reduction of Risk Potential

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