The nurse teaches a client scheduled for an upcoming total hip arthroplasty.
Which of the following statements by the client would require follow-up?
The nurse teaches a client scheduled for an upcoming total hip arthroplasty.
Which of the following statements by the client would require follow-up?
A. "I will need to bathe with chlorhexidine gluconate solution (CHG) the night before surgery to prevent an infection."
[17%]
B. "I will need to take deep breaths and cough hourly."
[7%]
C. "I will have to attend physical therapy sessions following my surgery."
[4%]
D. "I will be prescribed an anticoagulant and need to take it with a sip of water before the surgery."
[72%]
Statistics
Subject/Lesson
Subject
Fundamentals
Lesson
Perioperative Care
Client Need
Test Plan
Reduction of Risk Potential
Related Topic
Potential for Complications from Surgical Procedures and Health Alterations
Item Type
Item Type
Application
Explanation
Choice D is correct. After the surgery, the client will be prescribed VTE prevention (sequential compression devices, subcutaneous enoxaparin). The client should not take an anticoagulant or antiplatelet for 5-7 days or as directed by the surgeon before the surgery. This would raise the risk for intra- and postoperative hemorrhage. Other medications such as vitamin E, garlic, and aspirin should be avoided because these will increase the risk of bleeding.
Choice A is incorrect. Infection is a concern following this surgery, and the client will be prescribed to take a bath with CHG the night before. Once the bath has been completed, the client should then sleep on clean linens and not with pets.
Choice B is incorrect. The client will be instructed to deep breathe and cough and will be shown how to use the incentive spirometer. The clinical standard is hourly while they are awake.
Choice C is incorrect. Aggressive physical therapy (PT) is part of the postoperative process. The PT continues after the client has been discharged, and the client must adhere to these appointments.
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Anticoagulants
6.10 Hematology Drugs
Pre and Post Operative
12.9 Anesthesia & Perioperative Care
Additional Info
A total hip arthroplasty (THA) carries several postoperative complications
✓ To reduce the risk of a surgical site infection, the client is typically prescribed CHG soap so they can perform a CHG bath the night before. A preoperative antibiotic is typically administered within 60 minutes of the incision.
✓ To reduce the risk of pneumonia, the client will be instructed to deep breathe and cough and to use the incentive spirometer every 2 hours.
✓ To reduce the risk of venous thromboembolism, mechanical (sequential compression devices) and chemical (subcutaneous enoxaparin) prophylaxis are prescribed.
✓ To decrease the risk of hemorrhage, serial hemoglobin and hematocrit (H&H) levels may be ordered every six to eight hours for the first 24 hours postoperative.
