TOTAL HIP & KNEE REPLACEMENT (NCLEX)
Which type of traction is frequently used pre-op for total hip replacement? - Answer- Buck's
traction
Which check should be done post-op for both total hip & total knee replacements? - Answer-
Neurovascular checks
After a total hip or total knee replacement, the nurse should monitor the patients' drains (if they
have them) as we don't want ______. - Answer- fluid to accumulate within the tissues (this could
disrupt the suture lines)
Anytime you have a patient with an orthopeutic or joint problem, they need a ______ mattress
because ______. - Answer- firm; it provides support
After a total hip or total knee replacement, why does the patient need a firm mattress? - Answer-
Because the joints need support
After a total hip or total knee replacement, having an over the bed trapeze will help to _______ -
Answer- build upper body strength (good thing because when the patient starts to ambulate they'll
need that upper body strength with the walker and/or cane, etc)
After a total hip replacement, the position you want the patient in is a ______ rotation. - Answer-
neutral
______ refers to a position that involves the patient flat on their back (or HOB slightly elevated)
and their toes pointed at the ceiling with no twists or bends. - Answer- Neutral rotation
After a total hip replacement, what could happen if the patient was originally in neutral rotation but
has now turned their foot outward? - Answer- Hip could dislocate
After a total hip or total knee replacement, we want the patient to limit ______ of the hip as we
want ______ of the hip. - Answer- flexion; extension
When standing straight up, you are ______ your hip, and when you bend over, you are ______
your hip. - Answer- extending; flexing
After a total hip replacement, what could flexion of the hip do? - Answer- Dislocate the hip
After a total hip replacement, we want to avoid flexion of the hip, so they nurse need to be extra
careful when doing which 2 things? - Answer- Elevating the HOB & helping the patient get out of
bed
After a total hip replacement, do we want the patient in abduction or adduction? - Answer-
Abduction
In regard to wanting a post-op total hip patient to abduct, we want the patient to have their legs
_______ and their toes _______. - Answer- slightly apart; pointed up towards the ceiling
, What is the purpose of keeping a post-op total hip patient in abduction? - Answer- To keep the hip
in the socket (so we don't dislocate it - that's why they have those abductor pillows)
______ refers to the movement of a limb or other part away from the midline of the body, or from
another part. - Answer- Abduction
______ refers to the movement of a body part toward the body's midline. - Answer- Adduction
What exercises can the post-op total hip or total knee patient do while still confined to bed? -
Answer- Isometric exercises
Isometric exercise sizes can involve squeezing one's gluc's or quads as when the patient
squeezes these muscles, they enhance ______ and help to ______. - Answer- venous return;
maintain muscle tone
What's the purpose of the trochanter roll? - Answer- To prevent external rotation
______ refers to rolling up a towel/blanket and putting it along the greater trochanter to keep the
patients' foot from turning outwards. - Answer- Trochanter roll
In regard to total hip & total knee post-op patients, it's important for the nurses to document that
______ was in place. - Answer- trochanter roll
In regards to post-op for total hip and total knee replacement patients, there should be no ______
until prescribed by the primary healthcare provider. - Answer- weight-bearing
A post-op total hip patient needs to avoid ______ and ______ as these actions will cause their
new hip to dislocate. - Answer- crossing legs; bending over
In regard to sleep, what should the post-op total hip & total knee patients not do until the primary
healthcare provider says it's alright? - Answer- Sleep on the operated side (because that would
place undo pressure in that area)
Hydration is important for post-op total hip & total knee patients because they're at an increased
risk for ______ and ______ and so keeping the patient hydrated is one prevention method against
these. - Answer- DVT; PE
Post-op total hip & total knee patients are at an increased risk for blood clots (and DVT, PE, etc)
because they just _______ as well as they're pretty much ______ for the next little while. -
Answer- had ortho surgery; immobile
Post-op total hip & total knee patients are generally fairly immobile and so this increases their risk
for ______, ______, ______, and ______. - Answer- DVT; PE; general blood clots; pneumonia
Stresses to new hip & knee joints should be kept at a minimal for the first ______. - Answer- 3-6
months (after surgery)
Which type of traction is frequently used pre-op for total hip replacement? - Answer- Buck's
traction
Which check should be done post-op for both total hip & total knee replacements? - Answer-
Neurovascular checks
After a total hip or total knee replacement, the nurse should monitor the patients' drains (if they
have them) as we don't want ______. - Answer- fluid to accumulate within the tissues (this could
disrupt the suture lines)
Anytime you have a patient with an orthopeutic or joint problem, they need a ______ mattress
because ______. - Answer- firm; it provides support
After a total hip or total knee replacement, why does the patient need a firm mattress? - Answer-
Because the joints need support
After a total hip or total knee replacement, having an over the bed trapeze will help to _______ -
Answer- build upper body strength (good thing because when the patient starts to ambulate they'll
need that upper body strength with the walker and/or cane, etc)
After a total hip replacement, the position you want the patient in is a ______ rotation. - Answer-
neutral
______ refers to a position that involves the patient flat on their back (or HOB slightly elevated)
and their toes pointed at the ceiling with no twists or bends. - Answer- Neutral rotation
After a total hip replacement, what could happen if the patient was originally in neutral rotation but
has now turned their foot outward? - Answer- Hip could dislocate
After a total hip or total knee replacement, we want the patient to limit ______ of the hip as we
want ______ of the hip. - Answer- flexion; extension
When standing straight up, you are ______ your hip, and when you bend over, you are ______
your hip. - Answer- extending; flexing
After a total hip replacement, what could flexion of the hip do? - Answer- Dislocate the hip
After a total hip replacement, we want to avoid flexion of the hip, so they nurse need to be extra
careful when doing which 2 things? - Answer- Elevating the HOB & helping the patient get out of
bed
After a total hip replacement, do we want the patient in abduction or adduction? - Answer-
Abduction
In regard to wanting a post-op total hip patient to abduct, we want the patient to have their legs
_______ and their toes _______. - Answer- slightly apart; pointed up towards the ceiling
, What is the purpose of keeping a post-op total hip patient in abduction? - Answer- To keep the hip
in the socket (so we don't dislocate it - that's why they have those abductor pillows)
______ refers to the movement of a limb or other part away from the midline of the body, or from
another part. - Answer- Abduction
______ refers to the movement of a body part toward the body's midline. - Answer- Adduction
What exercises can the post-op total hip or total knee patient do while still confined to bed? -
Answer- Isometric exercises
Isometric exercise sizes can involve squeezing one's gluc's or quads as when the patient
squeezes these muscles, they enhance ______ and help to ______. - Answer- venous return;
maintain muscle tone
What's the purpose of the trochanter roll? - Answer- To prevent external rotation
______ refers to rolling up a towel/blanket and putting it along the greater trochanter to keep the
patients' foot from turning outwards. - Answer- Trochanter roll
In regard to total hip & total knee post-op patients, it's important for the nurses to document that
______ was in place. - Answer- trochanter roll
In regards to post-op for total hip and total knee replacement patients, there should be no ______
until prescribed by the primary healthcare provider. - Answer- weight-bearing
A post-op total hip patient needs to avoid ______ and ______ as these actions will cause their
new hip to dislocate. - Answer- crossing legs; bending over
In regard to sleep, what should the post-op total hip & total knee patients not do until the primary
healthcare provider says it's alright? - Answer- Sleep on the operated side (because that would
place undo pressure in that area)
Hydration is important for post-op total hip & total knee patients because they're at an increased
risk for ______ and ______ and so keeping the patient hydrated is one prevention method against
these. - Answer- DVT; PE
Post-op total hip & total knee patients are at an increased risk for blood clots (and DVT, PE, etc)
because they just _______ as well as they're pretty much ______ for the next little while. -
Answer- had ortho surgery; immobile
Post-op total hip & total knee patients are generally fairly immobile and so this increases their risk
for ______, ______, ______, and ______. - Answer- DVT; PE; general blood clots; pneumonia
Stresses to new hip & knee joints should be kept at a minimal for the first ______. - Answer- 3-6
months (after surgery)
