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Difficulty: MediumBasic Care and Comfort

An older adult patient is recovering in the surgical unit one day after receiving a left total hip arthroplasty via a posterior approach. When providing basic care and comfort measures, which action by the registered nurse demonstrates safe practice?

  1. Placing an abduction wedge between the patient's legs when turning them to the unaffected sideAnswer
  2. B
    Elevating the head of the bed to a full upright, 90-degree angle to comfortably feed the patient
  3. C
    Directing the unlicensed assistive personnel to conduct a baseline skin assessment on the surgical limb
  4. D
    Reassuring the family that the patient's sudden onset of acute confusion is a standard consequence of aging

Answer

Placing an abduction wedge between the patient's legs when turning them to the unaffected side
Following a posterior approach total hip arthroplasty, the hip must remain in an abducted position to prevent dislocation of the new prosthesis. An abduction wedge or pillow placed between the legs maintains this required alignment, especially when the patient is being repositioned or turned in bed.

Step-by-Step Solution

1
Analyze the patient's surgical procedure and postoperative requirements.
The patient had a posterior total hip arthroplasty, which requires specific positional precautions to prevent joint dislocation.
Understanding the anatomical risks of the specific surgical approach dictates safe positioning.
2
Evaluate each nursing action against posterior hip precautions and general safety standards.
Hip flexion must remain less than 90 degrees, and the surgical leg must remain abducted. Furthermore, assessments cannot be delegated, and sudden confusion is pathological.
Identifying contraindicated actions eliminates unsafe distractors.
3
Select the intervention that correctly aligns with physiological integrity and basic care principles.
Using an abduction wedge during turns is the only safe and appropriate action.
This directly applies the principle of maintaining proper anatomical alignment to prevent surgical complications.

Key Concept

Postoperative positioning and basic care following total hip arthroplasty
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Topics

Basic Care and Comfort

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