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Difficulty: EasyReduction of Risk Potential

An orthopedic nurse is reviewing postoperative orders for a client who underwent a right total hip arthroplasty using a posterolateral approach. To minimize the risk of prosthesis dislocation, which interventions should the nurse include in the daily care plan? Select all that apply.

  1. Position an abduction pillow between the client's lower extremities.Answer
  2. B
    Raise the head of the bed to a full upright 90-degree angle during meals.
  3. Maintain the affected right extremity in neutral alignment.Answer
  4. D
    Instruct the client to cross their legs at the ankles for comfort.
  5. Ensure the use of an elevated toilet seat for elimination needs.Answer

Answer

The correct interventions are positioning an abduction pillow between the legs, maintaining the affected extremity in neutral alignment, and using an elevated toilet seat.
Following a posterolateral total hip arthroplasty, the primary risk reduction strategy involves preventing dislocation of the newly placed joint. This requires strict adherence to hip precautions: avoiding adduction, internal rotation, and hip flexion greater than 90 degrees. Using an abduction wedge actively prevents adduction, keeping the leg in neutral alignment prevents internal rotation, and utilizing a raised toilet seat effectively prevents excessive hip flexion when sitting.

Step-by-Step Solution

1
Identify the surgical procedure and approach.
Right total hip arthroplasty using a posterolateral approach.
The surgical approach determines which specific postoperative movements are contraindicated to prevent joint dislocation.
2
Determine the contraindicated movements for a posterolateral approach.
Avoid hip adduction, internal rotation, and hip flexion greater than 90 degrees.
These specific positions and movements put excessive pressure on the posterior joint capsule, potentially forcing the new femoral head out of the socket.
3
Evaluate each nursing intervention against the contraindications.
Select the interventions that promote abduction, maintain neutral alignment, and prevent excessive hip flexion.
Choosing these actions directly reduces the risk of the severe physiological complication of joint dislocation.

Key Concept

Postoperative Risk Reduction: Total Hip Arthroplasty Precautions
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Topics

Reduction of Risk Potential

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