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Question

Difficulty: MediumReduction of Risk Potential

An older adult is recovering in the orthopedic unit after undergoing a right posterior total hip arthroplasty. The individual requires assistance with bowel elimination and requests a bedpan. To safely facilitate this without compromising the surgical site, which action is the most appropriate?

  1. Utilize a fracture pan while ensuring the right lower extremity remains in an abducted, neutral position.Answer
  2. B
    Adjust the bed's backrest to a 90-degree angle to simulate a normal sitting position for elimination.
  3. C
    Instruct the patient to cross the right ankle over the left leg to help leverage their hips upward.
  4. D
    Delegate the placement of the bedpan to unlicensed assistive personnel to ensure a prompt response.

Answer

Utilize a fracture pan while ensuring the right lower extremity remains in an abducted, neutral position.
The correct action involves using a fracture pan, which has a flat end that slides easily under the patient, requiring minimal lifting of the pelvis. Maintaining the operative leg in an abducted (away from the midline) and neutral position strictly adheres to posterior hip precautions, thereby reducing the risk of joint dislocation.

Step-by-Step Solution

1
Identify the surgical procedure and its associated risks.
The patient had a right posterior total hip arthroplasty.
Understanding the surgical approach determines the specific movement precautions required to prevent joint dislocation.
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 place stress on the posterior joint capsule, risking dislocation of the newly placed prosthesis.
3
Evaluate the options against these precautions.
Using a fracture pan with the leg abducted maintains joint safety. Sitting at 90 degrees or crossing legs violates the precautions.
A fracture pan has a lower profile, requiring minimal lifting of the pelvis, and keeping the leg abducted prevents the high-risk movement of adduction.

Key Concept

Post-operative Hip Arthroplasty Precautions
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Topics

Reduction of Risk Potential

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