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Difficulty: EasyBasic Care and Comfort

A client is recovering on the surgical unit following a right total hip arthroplasty (posterior approach). The nurse is assisting the client with positioning in bed. Which intervention should the nurse implement to prevent dislocation of the new hip prosthesis?

  1. Place an abductor pillow between the client's legs.Answer
  2. B
    Elevate the head of the bed to 90 degrees while the client is eating.
  3. C
    Instruct the client to cross their ankles to relieve muscle tension.
  4. D
    Position the client's right leg in internal rotation.

Answer

Place an abductor pillow between the client's legs.
Maintaining the hip in a state of abduction prevents the head of the femur from dislocating out of the acetabulum following a posterior approach total hip arthroplasty. An abductor pillow keeps the legs spread apart, maintaining this safe, neutral alignment.

Step-by-Step Solution

1
Analyze the surgical procedure and its inherent risks.
A posterior approach total hip arthroplasty carries a high risk of joint dislocation if specific movement precautions are not followed.
Understanding the surgical approach determines the necessary post-operative restrictions.
2
Identify the standard precautions for a posterior hip arthroplasty.
The primary restrictions are avoiding hip flexion greater than 90 degrees, avoiding hip adduction (crossing the midline), and avoiding internal rotation.
These specific movements place stress on the posterior capsule and can push the femoral head out of the acetabulum.
3
Evaluate the given options against these standard precautions.
Using an abductor pillow maintains safe alignment (abduction). The other choices describe actions that violate the restrictions (flexion > 90, adduction, internal rotation).
Selecting the intervention that actively prevents contraindicated movements ensures client safety.

Key Concept

Post-operative positioning and precautions for total hip arthroplasty
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Topics

Basic Care and Comfort

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