Fundamentals of Nursing Q 486
Nurse Sandra had just received a postoperative total hip replacement client from the recovery unit. Which is the best position in which she should place the client?
A. Side-lying with the affected leg externally rotated.
B. Side-lying with the affected leg internally rotated.
C. On the nonoperative side with the legs abducted.
D. On the nonoperative side with the legs adducted.
Correct Answer: C. On the nonoperative side with the legs abducted.
Abduction is maintained when the client is in a supine position or positioned on the non-operative side. The patient’s leg should be positioned in abduction. This is to prevent dislocation of the prosthesis. It is very crucial that the femoral head component of the acetabular cap is maintained in the correct position. Abduction splints, wedge pillows, and two or three pillows between the legs of the patient will keep the hip in abduction.
Option A: In cases where the patient needs to be turned, the operative hip must be kept in abduction and the entire length of the leg supported by pillows. The hip of the patient should NOT be flexed more than 45 to 60 degrees.
Option B: To prevent acute hip flexion, the head of the bed should not be elevated more than 45 degrees. Remind the patient not to sleep on the operated side until this position is cleared with the surgeon.
Option D: An abduction splint or pillows should be kept between the legs. The patient is encouraged to keep the operative hip in extension when transferring or sitting. The patient is instructed to pivot in the unoperated leg while assisted by the nurse, who protects the operative leg from adduction, flexion, and excessive weight-bearing.