During bedside rounds on an orthopedic unit, the charge nurse observes a newly hired nurse preparing to assist a client onto a bedpan. The client had a left total hip arthroplasty (posterior surgical approach) two days ago. Which action by the newly hired nurse demonstrates the safest technique for this procedure?
- AElevating the head of the bed to an 80-degree angle before asking the client to bridge their hips to accommodate a standard bedpan
- Instructing the client to maintain the left leg in a straight, neutral position while bending the right knee and pushing down to lift the pelvis for a fracture panAnswer
- CDirecting the client to roll onto their unaffected side with both knees resting together to allow placement of the fracture pan against the buttocks
- DAsking the client to cross their left ankle over the right lower leg to gain leverage while pulling up on the overhead trapeze bar
Answer
The safest technique is for the client to keep the operative (left) leg straight and neutral while bending the non-operative (right) knee to lift the pelvis, allowing the nurse to slide a fracture pan underneath.
Following a total hip arthroplasty with a posterior approach, the client must strictly avoid hip flexion greater than 90 degrees, hip adduction (crossing the midline), and internal rotation to prevent prosthesis dislocation. Instructing the client to keep the operative leg straight and neutral while using the non-operative leg to bridge the pelvis safely adheres to all hip precautions. Using a fracture pan is also correct, as its low profile requires less pelvic elevation than a standard bedpan.
Step-by-Step Solution
Key Concept
Basic Care and Comfort: Safe Client Positioning and Elimination