Zyvox 600 mg IV once a day is ordered for a patient. The Zyvox is dissolved in 300 mL of normal saline and should infuse over 1 hour. Using tubing with a drop factor of 10 gtt/mL, how many drops per minute should the Zyvox be infused?

Choice A reason: A visibly shorter leg and extreme pain post-hip arthroplasty suggest possible hip dislocation, a serious complication. Assessing neurovascular status (pulse, sensation, movement, color, temperature) in both legs is critical to detect compromised blood flow or nerve damage, which could lead to tissue ischemia or permanent injury if not addressed promptly.
Choice B reason: Elevating the leg and applying ice may reduce swelling but does not address the potential dislocation indicated by leg shortening and pain. These interventions could delay critical assessment and management of neurovascular compromise, potentially worsening outcomes in a suspected dislocation scenario.
Choice C reason: Administering pain medication may alleviate discomfort but does not address the underlying cause, such as a dislocated hip prosthesis. Pain relief is secondary to ensuring neurovascular integrity and confirming the surgical leg’s alignment, which are critical to prevent complications like tissue necrosis.
Choice D reason: Attempting to place the leg in abduction without confirming the cause of shortening and pain risks further damage, especially if the hip is dislocated. Manipulation could exacerbate neurovascular compromise or prosthesis misalignment, leading to prolonged recovery or additional surgical intervention.

Choice A reason: Uncemented hip arthroplasty requires careful transfer to prevent dislocation of the new joint, which relies on bone ingrowth for stability. Adequate help (e.g., two staff members) ensures safe transfer, minimizing stress on the surgical site and reducing the risk of falls or prosthesis misalignment.
Choice B reason: Providing socks to “slide easier” increases the risk of slipping during transfer, which could lead to falls or hip dislocation. Non-slip footwear is preferred to ensure stability and safety during mobilization post-hip arthroplasty.
Choice C reason: Full weight bearing is typically restricted after uncemented hip arthroplasty to allow bone ingrowth into the prosthesis. Informing the patient that full weight bearing is allowed is incorrect and could lead to implant failure or dislocation.
Choice D reason: Using a footstool to elevate the leg during transfer is inappropriate, as it may cause hip flexion beyond 90 degrees, increasing the risk of dislocation. Elevation is used in specific positions but not during initial transfers.