A nurse is developing a discharge plan for a client who is postoperative and will require a wheelchair in the home. The nurse should place a referral to which of the following resources to assist the client with this need?

The correct answer is b. Inform the assistive personnel of the client’s weight-bearing status.

Choice A: Assess the client’s incision every 8 hours for the first 48 hours. While it is important to monitor the incision site for signs of infection, the frequency of every 8 hours for the first 48 hours may not be necessary unless specified by the surgeon or the patient’s condition warrants it.

Choice B: Inform the assistive personnel of the client’s weight-bearing status. This is the correct answer. After a total hip arthroplasty, it’s crucial to communicate the client’s weight-bearing status to all members of the healthcare team, including assistive personnel. This helps ensure that everyone is aware of the client’s mobility limitations and can assist the client safely.

Choice C: Instruct the client to cross their legs at the ankles when sitting in a chair. This is not recommended. After a hip arthroplasty, patients are typically advised not to cross their legs to prevent dislocation of the new hip joint.

Choice D: Teach the client’s partner to assist the client to flex the hip at least 120° each hour. This is not recommended. After a hip arthroplasty, patients are typically advised to avoid flexing the hip more than 90 degrees to prevent dislocation of the new hip joint1. Therefore, flexing the hip at least 120° each hour could potentially harm the patient.

Choice A rationale:

Role model a positive approach to the changes. Rationale: The correct choice. As a charge nurse, leading by example is crucial. Demonstrating a positive attitude toward the changes sets a tone for the unit and encourages staff members to approach the situation with an open mind.

Choice B rationale:

Redirect the conversation when staff members make negative comments about the changes. Rationale: The correct choice. Addressing negativity and redirecting the conversation helps maintain a constructive and respectful work environment. This approach allows for open dialogue while discouraging excessive negativity that can hinder the adaptation process.

Choice C rationale:

Encourage staff members who support the changes to discuss the issue with resistant staff. Rationale: While encouraging open communication is important, it might not be sufficient to address the resistance completely. The charge nurse should take a more active role in managing negativity and facilitating a positive transition.

Choice D rationale:

Suggest that resistant staff members transfer to a different unit. Rationale: Transferring staff members might not be a productive solution and can lead to further discord within the unit. It's important to address the issues within the current team before considering such drastic measures.

Choice E rationale:

Reprimand staff members who are resistant to the changes. Rationale: Adopting a punitive approach can escalate tensions and foster a negative work environment. It's better to focus on positive reinforcement and facilitating open conversations to manage resistance effectively.