Total Hip Replacement

Question 1

What is a client requiring a Total hip Replacement usually in/require Pre-op ?

Answer 1

Buck’s Traction

is used frequently pre-op to immobilize the fracture

Question 2

TESTING STRATEGY:

Clients with Orthopedic or Joint problems require a firm mattress for support

Question 3

What are Nursing Considerations Post-op for a client who just had a Total Hip Replacement ?

Answer 3

• Neurovascular checks
• Monitor drains
• Firm mattress
• Over bed trapeze
• Proper positioning
• isometric exercises
• Trochanter roll
• No weight bearing (until prescribed by the HCP)
• Avoid crossing legs or bending over
• Do NOT sleep on the operated side
• Good hydration
• No pain meds in the operative hip

Question 4

Why do you want to monitor drains in a Post-op Total Hip Replacement client ?

Answer 4

B/c we don’t want fluid to accumulate in the tissues

Question 5

What do we want the positioning to be in a Post-op Total Hip Replacement client ?

Answer 5

• Want Neutral rotation (toes pointed to the ceiling)
• Limit flexion
• Want extension of the hip
• Want Abduction

Question 6

What is the purpose of the Trochanter roll in a Post-op Total Hip Replacement client ?

Answer 6

To prevent external rotation

Document Trochanter roll in the nurse’s not

Question 7

What is a Trochanter roll ?

Answer 7

Towel rolled up to keep good alignment

Question 8

Is it okay to sleep on the operated side in a Post-op Total Hip Replacement client ?

Answer 8

No

Question 9

Is Hydration important with a Post-op Total Hip Replacement client ?

Answer 9

Yes!

Because immobile

Question 10

Is it okay to give pain meds in the operative hip in a Post-op Total Hip Replacement client ?

Answer 10

No

Question 11

What are 4 complications in a Total Hip Replacement client ?

Answer 11

• Dislocation
• Infection
• Avascular Necrosis
• Immobility problems

Question 12

A dislocation in a Total Hip Replacement client can cause what ?

Answer 12

Circulatory and nerve damage

Question 13

What are signs and symptoms of Dislocation in a Total Hip Replacement client ?

Answer 13

• Shortening of leg
• abnormal rotation
• can’t move extremity
• Pain*

Question 14

With a (post-op) Total Hip Replacement client, how is infection prevented ?

Answer 14

Prophylactic antibiotics (just like with heart valve replacement)

Question 15

What do you want to remove as soon as possible in clients post-op Total hip replacement to prevent infection ?

Answer 15

Indwelling catheters and drains

(B/c these will serve as a portal for infection)

Question 16

Avascular Necrosis is a (post-op?) complication of a Total Hip Replacement. What is Avascular Necrosis ?

Answer 16

Death of tissue due to poor circulation

Question 17

What is the Best exercise for a client following a Toal hip replacement ?

Answer 17

Walking, swimming, rocking (chair)

Question 18

What do you want to avoid in clients Post-op Total Hip Replacement ?

Answer 18

Avoid flexion (b/c will cause dislocation)

So avoid…,

• Low chairs
• Traveling long distances
• Sitting more than 30 minutes
• Lifting heavy objects
• Excessive bending or twisting
• Stair climbing

Question 19

What do we want in clients post-op total hip replacement ?

Answer 19

Want Extension!