Hip Replacement Precautions on the NCLEX
Posterior precautions: no flexion past 90, no crossing, no internal rotation. Abduction pillow.
After a posterior-approach total hip, three movements can pop the new joint out. Every question tests one of them.
The three posterior precautions
1. No hip flexion beyond 90 degrees. No low chairs, low toilets, or bending to tie shoes. 2. No crossing the legs (no adduction past midline), sitting or lying. 3. No internal rotation. Toes stay pointing forward or slightly out. An abduction pillow or wedge between the legs in bed enforces the rules, especially when turning.
What daily life looks like
Raised toilet seat. Firm, high chair with armrests. Reacher, sock aid, and long-handled shoehorn instead of bending. No leaning forward past 90 to pick things off the floor. Pivot on the unaffected leg. Keep the knees below the hips when sitting.
Recognizing dislocation
Sudden severe hip pain, a popping sensation, the leg appears shortened and internally rotated, and the patient cannot bear weight. Do not move the leg. Keep the patient still and notify the provider immediately.
The rest of the post-op picture
DVT is the major complication: anticoagulant prophylaxis, SCDs, ankle pumps, early ambulation as ordered. Monitor the surgical drain and hemoglobin (these patients lose real blood). Incentive spirometry. Watch for fat embolism in the first days.
Frequently asked
Which visitor chair should the patient use?
The highest, firmest chair with armrests. Low soft chairs flex the hip past 90 degrees.
How does the patient safely get dressed?
Adaptive equipment: reacher, sock aid, long shoehorn. Dress the operative leg first without bending past 90.
Quick check
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