A nurse is reviewing the prescriptions for a client who is postoperative following a total hip arthroplasty. Which of the following prescriptions should the nurse clarify with the provider?

Instruct the client to limit flexion of the hips no further than 100".

Perform range-of-motion exercises every 2 hr.

Reposition the client every 2 hr.

Place an abduction pillow between the legs.

Answer and Explanation

The Correct Answer is A

A. Limiting hip flexion to 100" is an incorrect and potentially unsafe prescription. Such a restriction would severely limit the client's mobility and could impede the recovery process following a total hip arthroplasty. The nurse should clarify this prescription with the provider to ensure that the client is given appropriate instructions for postoperative care.

B. Performing range-of-motion exercises every 2 hours is a standard and appropriate prescription for a postoperative client after a total hip arthroplasty. These exercises help prevent joint stiffness and promote circulation.

C. Repositioning the client every 2 hours is a standard practice to prevent complications such as pressure ulcers and promote comfort and circulation.

D. Placing an abduction pillow between the legs is a common practice after a total hip arthroplasty. It helps maintain proper hip alignment and prevents dislocation of the prosthetic hip joint during the initial postoperative period.

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Correct Answer is C

Explanation

A. A staff member places a midstream urine sample in a specimen refrigerator after collecting it: This action is appropriate as long as the specimen is labeled correctly and stored at the correct temperature. Proper handling of specimens is essential for accurate testing and does not represent an infection control hazard.

B. A staff member wipes a countertop with chlorhexidine solution to clean the area following a blood spill: This action is appropriate for cleaning a contaminated surface. Chlorhexidine is an effective disinfectant for blood spills. Therefore, this action does not represent an infection control hazard.

C. A nurse uses alcohol-based antiseptic to clean his hands after talking with a client who has varicella zoster: While alcohol-based antiseptics are effective for most pathogens, varicella zosteris primarily spread through direct contact and airborne transmission. It is recommended to wash hands with soap and water after caring for a patient with varicella zoster, especially if hands are visibly soiled. This action may not adequately control the infection hazard.

D. A nurse pours sterile 0.9% sodium chloride irrigation solution on an open pressure wound prior to collecting a specimen for culture: This action is appropriate as long as sterile technique is maintained. Using sterile saline for irrigation is standard practice to minimize the risk of introducing pathogens before specimen collection. Therefore, this action does not represent an infection control hazard.

A. Use of the Braden scale for clients who are immobile B. Daily weighing of clients who have heart failure C. Documentation of PAINAD scale for clients who have dementia D. Implementation of incentive spirometry for clients who are postoperative

Correct Answer is A

Explanation

A. Use of the Braden scale for clients who are immobile.

The Braden Scale is a widely used tool for assessing the risk of pressure ulcer development. It includes various factors such as sensory perception, moisture, activity, mobility, nutrition, and friction/shear. For clients who are immobile, the Braden Scale helps identify their risk for skin breakdown and guides the implementation of preventive measures.

B. Daily weighing of clients who have heart failure:

Daily weighing of clients with heart failure is important for monitoring fluid status, but it is not specifically focused on decreasing the risk of skin breakdown. Skin breakdown is more closely related to factors such as immobility, pressure, and friction.

C. Documentation of PAINAD scale for clients who have dementia:

The PAINAD scale is used to assess pain in clients with advanced dementia. While managing pain is important for overall well-being, it is not a direct measure for decreasing the risk of skin breakdown. Skin breakdown prevention is more related to factors like pressure relief and moisture management.

D. Implementation of incentive spirometry for clients who are postoperative:

Incentive spirometry is primarily aimed at promoting lung expansion and preventing respiratory complications after surgery. While postoperative care is essential, it does not directly address the risk of skin breakdown. Skin breakdown prevention involves interventions related to pressure relief, repositioning, and skin care.

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A nurse is reviewing the prescriptions for a client who is postoperative following a total hip arthroplasty. Which of the following prescriptions should the nurse clarify with the provider?

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