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Difficulty: EasyBasic Care and Comfort

A nurse is planning care for a client who is postoperative following a right total hip arthroplasty via a posterior approach. Which action regarding the client's positioning and basic care is correct?

  1. A
    Elevating the head of the bed to a full 90-degree angle when the client is eating meals.
  2. B
    Instructing the client to cross their legs at the ankles to reduce pressure on the heels.
  3. Placing an abductor wedge between the client's legs while the client is resting in bed.Answer
  4. D
    Delegating the initial postoperative repositioning of the client to unlicensed assistive personnel (UAP).

Answer

Placing an abductor wedge between the client's legs while the client is resting in bed.
For a client who has undergone a total hip arthroplasty with a posterior approach, maintaining the hip in a state of abduction is critical to prevent dislocation of the prosthesis. Using an abductor wedge or pillows between the legs keeps the hip properly aligned and prevents accidental adduction.

Step-by-Step Solution

1
Identify the surgical procedure and approach from the client's history.
The client underwent a total hip arthroplasty utilizing a posterior approach.
The specific surgical approach dictates the movement precautions necessary to maintain joint stability.
2
Determine the necessary positioning precautions for a posterior approach.
Standard precautions include avoiding hip flexion greater than 90 degrees, avoiding hip adduction (crossing the midline), and avoiding internal rotation.
These specific movements place excessive stress on the posterior joint capsule and can force the prosthetic head out of the socket.
3
Evaluate each nursing action against these safety precautions.
Using an abductor wedge maintains the required abduction and prevents adduction, making it the safe and correct nursing action.
The other proposed actions involve contraindicated movements (excessive flexion, adduction) or improper delegation of an initial nursing assessment.

Key Concept

Following a total hip arthroplasty with a posterior approach, nursing care must focus on maintaining abduction and avoiding hip flexion greater than 90 degrees to prevent prosthesis dislocation.
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Basic Care and Comfort

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