Physiological Adaptation Q 313
A nurse is caring for a patient who has had hip replacement. The nurse should be most concerned about which of the following findings?
A. Complaints of pain during repositioning.
B. Scant bloody discharge on the surgical dressing.
C. Complaints of pain following physical therapy.
D. Temperature of 101.8 F (38.7 C).
Correct Answer: D. Temperature of 101.8 F (38.7 C).
Post-surgical nursing assessment after hip replacement should be principally concerned with the risk of neurovascular complications and the development of infection. A temperature of 101.8 F (38.7 C) postoperatively is higher than the low grade that is to be expected and should raise concern. The THA postoperative wound complication spectrum ranges from superficial surgical infections (SSIs) such as cellulitis, superficial dehiscence, and/or delayed wound healing, to deep infections resulting in full-thickness necrosis. Deep infections result in returns to the operating room for irrigation, debridement (incision and drainage) and depending on the timing of the infection, may require explanation of THA components.
Option A: Joint replacement surgery relieves the pain and stiffness of arthritis for most people. Some people may still have some symptoms of arthritis. For most people, surgery usually provides enough relief of symptoms for most people. Loosening of the new joint over time can cause pain, and sometimes another surgery is needed to fix the problem.
Option B: A small amount of bloody drainage on the surgical dressing is a result of normal healing. normal to lose blood during and after hip or knee replacement surgery. Some people need a blood transfusion during surgery or during their recovery period in the hospital. Some surgeries require you to donate blood before surgery. Much of the bleeding during surgery comes from the bone that has been cut. A bruise may occur if blood collects around the new joint or under the skin after surgery.
Option C: Some pain following physical therapy is to be expected and can be managed with analgesics. As in its counterpart TKA procedure, aseptic loosening is the result of a confluence of steps involving particulate debris formation, prosthesis micromotion, and macrophage-activated osteolysis. Treatment requires serial imaging and radiographs and/or CT imaging for preoperative planning. Persistent pain requires revision THA surgery.