Nokea
A patient was brought to the emergency department after a fall. The patient is taken to the operating room to receive a right hip prosthesis. In the immediate postoperative period, what health education should the nurse emphasize?
- A. Make sure you don't bring your knees close together.
- B. Try to lie as still as possible for the first few days.
- C. Try to avoid bending your knees until next week.
- D. Keep your legs higher than your chest whenever you can.
Correct Answer: A
Rationale: After receiving a hip prosthesis, the affected leg should be kept abducted. Mobility should be encouraged within safe limits. There is no need to avoid knee flexion and the patient's legs do not need to be higher than the level of the chest.
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A nurse is reviewing a patient's activities of daily living prior to discharge from total hip replacement. The nurse should identify what activity as posing a potential risk for hip dislocation?
- A. Straining during a bowel movement
- B. Bending down to put on socks
- C. Lifting items above shoulder level
- D. Transferring from a sitting to standing position
Correct Answer: B
Rationale: Bending to put on socks or shoes can cause hip dislocation. None of the other listed actions poses a serious threat to the integrity of the new hip.
A patient has had a brace prescribed to facilitate recovery from a knee injury. What are the potential therapeutic benefits of a brace? Select all that apply.
- A. Preventing additional injury
- B. Immobilizing prior to surgery
- C. Providing support
- D. Controlling movement
- E. Promoting bone remodeling
Correct Answer: A,C,D
Rationale: Braces (i.e., orthoses) are used to provide support, control movement, and prevent additional injury. They are not used to immobilize body parts or to facilitate bone remodeling.
A nurse is caring for a patient who has had a total hip replacement. The nurse is reviewing health education prior to discharge. Which of the patient's statements would indicate to the nurse that the patient requires further teaching?
- A. I'll need to keep several pillows between my legs at night.
- B. I need to remember not to cross my legs. It's such a habit.
- C. The occupational therapist is showing me how to use a sock puller to help me get dressed.
- D. I will need my husband to assist me in getting off the low toilet seat at home.
Correct Answer: D
Rationale: To prevent hip dislocation after a total hip replacement, the patient must avoid bending the hips beyond 90 degrees. Assistive devices, such as a raised toilet seat, should be used to prevent severe hip flexion. Using an abduction pillow or placing several pillows between the legs reduces the risk of hip dislocation by preventing adduction and internal rotation of the legs. Likewise, teaching the patient to avoid crossing the legs also reduces the risk of hip dislocation. A sock puller helps a patient get dressed without flexing the hips beyond 90 degrees.
A patient is complaining of pain in her casted leg. The nurse has administered analgesics and elevated the limb. Thirty minutes after administering the analgesics, the patient states the pain is unrelieved. The nurse should identify the warning signs of what complication?
- A. Subcutaneous emphysema
- B. Skin breakdown
- C. Compartment syndrome
- D. Disuse syndrome
Correct Answer: C
Rationale: Compartment syndrome may manifest as unrelenting, uncontrollable pain. This presentation of pain is not suggestive of disuse syndrome or skin breakdown. Subcutaneous emphysema is not a complication of casting.
A nurse is admitting a patient to the unit who presented with a lower extremity fracture. What signs and symptoms would suggest to the nurse that the patient may have a peroneal nerve injury?
- A. Numbness and burning of the foot
- B. Pallor to the dorsal surface of the foot
- C. Visible cyanosis in the toes
- D. Inadequate capillary refill to the toes
Correct Answer: A
Rationale: Peroneal nerve injury may result in numbness, tingling, and burning in the feet. Cyanosis, pallor, and decreased capillary refill are signs of inadequate circulation.