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Zorluk: OrtaBasic Care and Comfort

A practical nurse is providing care for a client who had a right total hip arthroplasty using a posterior approach the previous day. The nurse is preparing to assist the client with repositioning and comfort measures in bed. Which of the following actions is the most appropriate to maintain proper alignment and prevent joint dislocation?

  1. Place an abduction wedge or pillow between the client's legs while turning them.Cevap
  2. B
    Elevate the head of the bed to a 90-degree angle while the client eats their meals.
  3. C
    Support the right leg with a trochanter roll to encourage internal rotation of the hip.
  4. D
    Allow the client to cross their legs at the ankles while resting in a supine position.

Cevap

Place an abduction wedge or pillow between the client's legs while turning them.
Following a total hip arthroplasty with a posterior approach, maintaining abduction is a critical priority. Using an abduction wedge or pillow between the legs during turning prevents the affected leg from crossing the body's midline (adduction). This maintains the proper alignment of the femur in the acetabulum and prevents posterior dislocation of the prosthesis.

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1
Identify the type of surgery and the associated movement precautions.
The client had a right total hip arthroplasty via a posterior approach. Precautions include avoiding hip flexion greater than 90 degrees, avoiding internal rotation, and avoiding adduction (crossing the midline).
Understanding surgical precautions is essential for planning safe basic care and positioning.
2
Evaluate each nursing action against the established hip precautions.
Using an abduction pillow prevents adduction and is the correct action. Sitting at 90 degrees causes excessive flexion. Encouraging internal rotation or crossing legs (adduction) directly violates precautions and risks dislocation.
Applying the precautions to routine comfort measures ensures the prosthesis remains stable during recovery.

Anahtar Kavram

Postoperative Positioning and Hip Precautions
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