Question

Paula Jones is a 65-year-old retired nurse who had an open reduction with internal fixation (ORIF) of the right hip yesterday. Vital signs remain stable within the client’s baseline. The client is receiving hydromorphone (Dilaudid) via PCA for pain. The client uses the incentive spirometer every hour as instructed. An abduction pillow is positioned between the client’s legs.

What position constraints must be observed when turning and repositioning this client?

Answer 1

With open reduction internal fixation of hip the following position of the hips are contraindicated:

1. adduction of the hips

2. External rotation of the hip

3. planter or dorsoflexion of foot

4. Hyperextension of hip

It is important to change the patient position at regular intervals to avoid pressure sores and flexion - extension contractures of the hip.
The patient should be asked to flex his knee at regular intervals to avoid backache and release hamstring tension.
The patient can also move side to sideand elevation of backrest at regular intervals can be done.
While turning in the bed pillow ahould be kept between the legs to prevent hip adduction. Pillow or sand bag can also be kept below the foot to avoid dorsiflexion.
A sand bag can also be used at lateral aspect of thigh to prevent external rotation of hip.