Ch. 18: Hip and Knee (Nurs 309)

A client has a total knee replacement, and a continuous passive motion device is being used. The nurse concludes that the teaching was effective when the client states, "The goal of therapy is to: 1. "Improve joint flexion." 2. "Maintain muscle tone." 3. "Prevent tissue breakdown." 4. "Avoid formation of a clot."

1. "Improve joint flexion."

A nurse recieves a change of shift report for a client who had a total hip replacement 24 hours ago. After reviewing the client's clinical record and completing a physical assessment, which complication should the nurse conclude that the client is experiencing? 1. Fat embolism 2. Urinary retention 3. Hypovolemic shock 4. Pulmonary embolism

1. Fat embolism

A nurse provides discharge teaching for a client who had a total hip replacement. Which activities to avoid identified by the client indicate an understanding of the teaching? Select All That Apply. 1. Climbing stairs. 2. Crossing the legs. 3. Stretching exercises. 4. Sitting in a low chair. 5. Lying in prone for 30 minutes.

2. Crossing the legs. 4. Sitting in a low chair.

A client has a total hip replacement. Which clinical indicators of pulmonary embolism indicate that the plan to prevent postoperative thrombus formation has been ineffective? Select All That Apply. 1. Flushing of the face. 2. Unilateral chest pain. 3. Elevation of temperature. 4. Sudden onset of shortness of breath. 5. Pain rating increase from 2-8 in the hip.

2. Unilateral chest pain. 4. Sudden onset of shortness of breath.

Which position should the nurse avoid placing a client who had surgery for a total hip replacement? 1. Supine 2. Lateral 3. Orthopneic 4. Semi-fowler

3. Orthopneic

A nurse is teaching crutch-walking to a client who had arthroscopic surgery of the knee. On which part of the body should the nurse instruct the client to place weight? 1. The upper arms. 2. The axillary region. 3. Palms of the hands. 4. Both lower extremities.

3. Palms of the hands.

A client is ready to walk with crutches after knee surgery. Which crutch-walking technique will the nurse most likely have to reinforce after the client returns from physical therapy? 1. Two-point. 2. Four-point. 3. Three-point. 4. Swing-through.

3. Three-point.

A client has a total hip arthroplasty. What should the nurse do when caring for this client after surgery? 1. Use a pillow to keep the leg abducted. 2. Elevate the client's affected limb. 3. Turn the client using the log-rolling technique. 4. Place a trochanter roll along the entire extremity.

1. Use a pillow to keep the leg abducted.

When a client is in the right-side-lying position after the insertion of of a left hip prosthesis, the nurse ensures that the client has a pillow placed between the thighs and that the entire length of the upper leg is supported. What does this pillow prevent? 1. Strain on the operative site. 2. Thrombus formation in the leg. 3. Flexion contractures of the hip joint. 4. Skin surfaces from rubbing together.

1. Strain on the operative site.

A nurse is caring for a client who had a total hip replacement. What nursing action should be incorporated into the plan of care to prevent thrombus formation? 1. Turning the client from side to side. 2. Encouraging the client to perform ankle exercises. 3. Getting the client up to sit in a chair for as long as tolerated. 4. Ambulating the client when the effects of anesthesia subside.

2. Encouraging the client to perform ankle exercises.

A nurse is caring for a client who had a total hip replacement. What is the priority assessment when monitoring the client for hemorrhage? 1. Checking vital signs every 4 hours. 2. Examining the bedding under the client. 3. Measuring the circumference of the thigh. 4. Observing for ecchymosis at the operative site.

2. Examining the bedding under the client.

The nurse is caring for a postoperative patient with a hip replacement. Which patient care actions can be delegated to the experienced UAP. Select All That Apply. 1. Inspect heels and other bony prominences every 8 hours. 2. Turn and reposition the patient every 2 hours. 3. Assure that the patient's heels are elevated off the bed. 4. Assess the patient's calf regions for redness and swelling. 5. Check vital signs and oxygen saturation via pulse oximetry. 6. Assess for pain and administer pain medication.

2. Turn and reposition the patient every 2 hours. 3. Assure that the patient's heels are elevated off the bed. 5. Check vital signs and oxygen saturation via pulse oximetry.

On the first postoperative day after a total hip replacement a client asks for assistance onto the bedpan. What should the nurse instruct the patient to do? 1. Use the elbows and hands to lift the pelvis off the bed. 2. Extend both legs and pull on the trapeze to lift the pelvis. 3. Turn gently toward the opposite side while lifting the pelvis off the bed. 4. Flex the knee on the unoperated leg and pull on the trapeze to lift off the pelvis.

4. Flex the knee on the unoperated leg and pull on the trapeze to lift off the pelvis.