A nurse is caring for a client who is postoperative following a total left hip arthroplasty. Which of the following actions should the nurse take?
Cross the client's legs when sitting in the recliner.
Provide a heating pad to the operative hip.
Place a pillow between the legs when turning the client to their side.
Have the client lean forward when assisting them out of the bed.
The Correct Answer is C
Choice A rationale:
The nurse should not cross the client's legs when sitting in the recliner following a total left hip arthroplasty. Crossing the legs can put strain on the operative hip and may increase the risk of dislocation or other complications.
Choice B rationale:
Providing a heating pad to the operative hip is not recommended. Heat can increase blood flow to the area and may lead to increased swelling and potential complications in the postoperative period.
Choice C rationale:
Placing a pillow between the legs when turning the client to their side is the correct action. This technique is known as the "abduction pillow”. or "wedge pillow.”. It helps maintain proper hip alignment and prevents the operated leg from crossing the midline, reducing the risk of dislocation and promoting healing.
Choice D rationale:
Having the client lean forward when assisting them out of the bed is not appropriate after a total left hip arthroplasty. Leaning forward can put strain on the hip joint and increase the risk of injury.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Properly cutting the opening on the skin barrier wafer to fit over the stoma is crucial to prevent any irritation or damage to the surrounding skin. A well-fitted wafer creates a seal around the stoma, reducing the risk of stool coming into contact with the skin, which can cause excoriation.
Choice B rationale:
Emptying the bag when it is three-fourths full of stool is unrelated to the education on colostomy care. This information was provided in the previous question () and is not relevant to colostomy care education.
Choice C rationale:
The color of the stoma should not be slightly purple. A healthy stoma should be pink or red, indicating a good blood supply. A purple or dark-colored stoma could indicate inadequate blood flow, which is a concern and requires immediate medical attention.
Choice D rationale:
Cleansing the peristomal skin with moisturizing soap and water is not the recommended approach. The nurse should use plain water or mild, non-moisturizing soap to clean the peristomal skin, as moisturizing soap may leave a residue that affects the adhesion of the skin barrier wafer.
Correct Answer is B
Explanation
Let's break down the calculation:
Given:
- Patient weight: 154 lbs
- Enoxaparin dosage: 0.75 mg/kg
- Available enoxaparin: 60 mg/0.6 mL
Step 1: Convert pounds to kilograms:
- 1 lb is approximately 0.4536 kg
- So, 154 lbs = 154 * 0.4536 kg/lb = 69.85 kg (approximately 70 kg)
Step 2: Calculate the total dose of enoxaparin:
- Desired dose = 0.75 mg/kg * 70 kg = 52.5 mg
Step 3: Determine the volume to administer:
- We have enoxaparin 60 mg/0.6 mL
- To find the volume for 52.5 mg:
- (52.5 mg / 60 mg) * 0.6 mL = 0.525 mL
- Rounded to the nearest tenth, this is 0.5mL.
Therefore, the nurse should administer 0.5mL of enoxaparin
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