A nurse is caring for a client who had a total right hip arthroplasty. In which of the following positions should the nurse place the client to prevent complications?
Prone with the legs adducted
Side-lying on the affected side
Supine with the head slightly elevated
High-Fowler's with a pillow under the knees
The Correct Answer is C
A. Prone with the legs adducted: Prone positioning is not recommended after hip arthroplasty as it places pressure on the surgical site and does not support proper hip alignment. Adduction of the legs increases the risk of hip dislocation.
B. Side-lying on the affected side: Lying on the operative side can cause pain and increase pressure on the hip joint, which may compromise healing. It is generally recommended to avoid side-lying positions unless specifically advised by the provider.
C. Supine with the head slightly elevated: Keeping the client in a supine position with the head elevated and the legs abducted helps maintain proper hip alignment and reduces the risk of dislocation. A wedge or abduction pillow is often used to prevent the legs from crossing.
D. High-Fowler's with a pillow under the knees: A high-Fowler's position increases hip flexion beyond the recommended 90-degree limit, which can lead to dislocation. Placing a pillow under the knees can also increase the risk of venous stasis and deep vein thrombosis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","D","E"]
Explanation
- "The iron supplement might cause my stools to be black.": This statement is correct as one of the common side effects of iron supplementation is darkening of the stools. This occurs due to the unabsorbed iron and is generally harmless, but clients should be educated about this to avoid confusion with gastrointestinal bleeding.
- "I should increase green leafy vegetables in my diet.": Green leafy vegetables are excellent sources of iron, particularly non-heme iron, which can help improve the client's iron levels. Encouraging a diet rich in iron-rich foods is essential for effective management of iron deficiency anemia, especially for clients on a vegan diet.
- "I will take my iron supplement 1 hour before a meal.": Taking iron supplements on an empty stomach enhances absorption. Clients should be instructed to take the supplement ideally 1 hour before meals or 2 hours after meals for optimal efficacy, unless gastrointestinal discomfort occurs.
- "I should expect to have swelling in my feet.": This statement is not appropriate. Swelling in the feet may indicate fluid retention or other medical issues that should be reported. It is not a typical or expected side effect of iron supplementation or iron deficiency anemia.
- "The iron supplement might cause ringing in my ears.": Ringing in the ears (tinnitus) is not a common side effect of iron supplements. If a client experiences this symptom, it may be related to other factors or medications and should be investigated further.
Correct Answer is C
Explanation
A. 150 mL of greenish yellow NG drainage: This amount and color of drainage are expected after abdominal surgery, as bile-stained gastric contents can be present. It does not indicate a complication that requires provider notification.
B. Client requests medication for nausea: Nausea is a common postoperative symptom, often managed with antiemetics. While it should be addressed, it is not an urgent finding that requires immediate provider notification.
C. Urinary output of 250 mL over past 12 hr: Oliguria, defined as urine output less than 30 mL/hr (or less than 400 mL in 24 hr), suggests inadequate renal perfusion, possibly due to hypovolemia or acute kidney injury. This finding requires prompt provider notification.
D. Hypoactive bowel sounds: Reduced bowel activity is common after abdominal surgery due to anesthesia and opioid use. While monitoring is necessary, hypoactive sounds alone are not an urgent concern unless accompanied by other signs of ileus or obstruction.
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