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Difficulty: MediumSelf-Care

A home care nurse is evaluating the self-care management of an older adult client recovering from a right total hip arthroplasty (posterior approach). Which action or statement by the client indicates an accurate understanding of their self-care instructions?

  1. A
    The client states that a recent, sudden onset of urinary incontinence is just a normal expectation of aging.
  2. B
    The client leans forward past a 90-degree hip angle while seated to independently put on socks.
  3. The client uses a long-handled reacher device to retrieve a dropped item from the floor.Answer
  4. D
    The client describes their daily post-surgical rehabilitation exercises as a form of primary disease prevention.

Answer

The client correctly uses a long-handled reacher device to retrieve dropped items, which maintains necessary hip precautions.
Clients recovering from a posterior approach total hip arthroplasty must avoid hip flexion greater than 90 degrees to prevent dislocation. Using assistive devices like a long-handled reacher allows the client to perform activities of daily living (ADLs) independently without compromising the new joint.

Step-by-Step Solution

1
Identify the client's surgical procedure and the associated anatomical risks.
The client had a right total hip arthroplasty via a posterior approach, which carries a high risk of dislocation if the hip is flexed beyond 90 degrees.
Understanding the specific surgical approach dictates which movements are contraindicated during independent self-care.
2
Evaluate each client action or statement for safety and accuracy regarding self-care and general health maintenance.
Leaning forward to put on socks violates hip precautions. Misidentifying rehab as primary prevention and dismissing sudden incontinence as normal aging are both incorrect health beliefs.
Distinguishing safe, correct health behaviors from unsafe or misguided ones is necessary to determine if self-care teaching was effective.
3
Select the option that demonstrates safe, independent adherence to the prescribed restrictions.
Using a reacher device allows the client to retrieve items without bending the hip past 90 degrees.
Adaptive equipment is a cornerstone of safe self-care for clients with movement restrictions.

Key Concept

Total Hip Arthroplasty (Posterior Approach) Self-Care Precautions
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Topics

Self-Care

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