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Question

Difficulty: MediumBasic Care and Comfort

A registered nurse and a nursing assistant are preparing to provide morning hygiene care and reposition an 82-year-old client who underwent a right posterior total hip arthroplasty the previous day. Which directive from the nurse is appropriate for safely managing this client's comfort and mobility during the bath?

  1. Keep a specialized wedge securely between the client's thighs while rolling them onto their left side.Answer
  2. B
    Assist the client into a full upright seated posture while washing their upper back and shoulders.
  3. C
    Determine if the client is experiencing any new incisional tenderness before we begin the bed bath.
  4. D
    Disregard any sudden onset of disorientation the client exhibits today, as brief cognitive decline is an expected baseline for octogenarians.

Answer

The correct action is to keep a specialized wedge securely between the client's thighs while rolling them onto their left side.
Following a posterior total hip arthroplasty, maintaining hip abduction is critical to prevent the newly implanted joint from popping out of the socket. Using an abduction wedge between the client's legs while turning them on their side ensures the operative leg does not cross the midline (adduct), allowing for safe hygiene care and positioning.

Step-by-Step Solution

1
Identify the client's surgical procedure and specific post-operative restrictions.
The client had a posterior total hip arthroplasty, which requires preventing hip flexion greater than 90 degrees, adduction, and internal rotation.
Understanding structural restrictions dictates safe mobility and hygiene practices.
2
Evaluate the nursing assistant's scope of practice regarding the planned interventions.
Nursing assistants can safely perform basic hygiene and positioning tasks but cannot independently assess pain or clinical status.
Safe delegation ensures that only appropriate personnel handle specific, non-judgment-based tasks.
3
Select the intervention that promotes hygiene and comfort while strictly adhering to surgical precautions and delegation rules.
Instructing the assistant to use an abduction wedge during turning allows for safely bathing the back and buttocks without risking hip dislocation.
This directly addresses basic care needs while maintaining the client's physiological integrity.

Key Concept

Safe client positioning, mobility, and delegation post-arthroplasty
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Topics

Basic Care and Comfort

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