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

Answer and Explanation

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.

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Correct Answer is ["A","B","C","D","H"]

Explanation

Hematocrit: The client's hematocrit level of 24% is significantly low (normal range: 37% to 47%), indicating anemia. This requires follow-up to determine the underlying cause and initiate appropriate treatment, such as iron supplementation or further investigation.
Oxygen saturation: An oxygen saturation level of 94% is slightly low, especially considering the client's reported shortness of breath. Monitoring is necessary to ensure adequate oxygenation and to assess if supplemental oxygen or further respiratory evaluation is needed.
Activity level: The client reports generalized weakness and increased fatigue, particularly becoming short of breath after minimal exertion (e.g., climbing stairs). This decreased activity level is concerning and may indicate cardiovascular or hematological issues, requiring further assessment and follow-up.
Blood pressure: The blood pressure readings indicate orthostatic hypotension, with a drop from 118/60 mm Hg sitting to 102/50 mm Hg standing. This significant drop suggests potential volume depletion or anemia, which requires follow-up to assess fluid status and ensure safety during ambulation.
Vitamin B12 level: The Vitamin B12 level of 159 pg/mL is slightly below the normal range (160 to 950 pg/mL), indicating potential deficiency. This can lead to anemia and neurological issues. Follow-up is needed to evaluate dietary intake and consider supplementation.

Temperature: The client's temperature of 37° C (98.6° F) is within normal limits and does not indicate a need for follow-up. Monitoring for signs of infection or inflammation is important, but this finding is stable.
Breath sounds: The assessment shows clear and present bilateral breath sounds, which indicate no respiratory distress or abnormalities. This finding does not require follow-up.
Pain level: The client reports no pain or discomfort, which is a positive finding and does not necessitate further follow-up. Ongoing assessment for pain should continue, but current findings are stable.

A. Chest tube with a drainage system B. NG tube with suction apparatus C. Chest physiotherapy vest D. Peak flow meter

Correct Answer is C

Explanation

A. Chest tube with a drainage system: A chest tube is typically used for pneumothorax or pleural effusion, not as a routine treatment for cystic fibrosis. While some clients with severe lung disease may require one in emergencies, it is not standard home care equipment.

B. NG tube with suction apparatus: While some clients with cystic fibrosis may require enteral feeding for nutritional support, an NG tube with suction is not a standard home intervention. Suctioning is generally needed for acute gastrointestinal obstruction rather than routine CF management.

C. Chest physiotherapy vest: This device helps loosen and mobilize thick mucus from the airways, improving airway clearance and reducing the risk of infections. It is a critical component of daily CF management and is commonly used in home settings.

D. Peak flow meter: A peak flow meter is more commonly used in asthma to monitor airway obstruction. In CF, lung function is better assessed with spirometry rather than peak expiratory flow, making this device less useful for routine home monitoring.

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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?

Nursing Test Bank

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