Pathophysiology: Definition: Hip replacement surgery is a procedure in which a doctor surgically removes a painful hip joint with arthritis

and replaces it with an artificial joint. It usually is done when all other treatment options have failed to provide adequate pain relief. Management of hip replacement: Use an abduction pillow or splint to prevent adduction after surgery if the patient is very restless or has an altered mental state. Keep the patient's heels off the bed to prevent pressure ulcers. Do not rely on fever as a sign of infection; older patients often have infection without fever. Decreasing mental status typically occurs when the patient has an infection. When assisting the patient out of bed, move him or her slowly to prevent orthostatic (postural) hypotension. Encourage the patient to deep breathe and cough, and use the incentive spirometer every 2 hours to prevent atelectasis and pneumonia. As soon as permitted, get the patient out of bed to prevent complications of immobility. Anticipate the patient's need for pain medication, especially if he or she cannot verbalize the need for pain control. Expect a temporary change in mental state immediately after surgery as a result of the anesthetic and unfamiliar sensory stimuli. Reorient the patient frequently. Observe for possible signs of hip dislocation, which include increased hip pain, shortening of the affected leg, and leg rotation. The most potentially life-threatening complication after THA is venous thromboembolism (VTE), which includes deep venous thrombosis (DVT) and pulmonary embolism (PE). Older patients are especially at increased risk for VTE because of age and compromised circulation before surgery Post operative care: The surgeon also requests periodic hemoglobin and hematocrit (H&H) tests to assess for anemia. Check and document color, temperature, distal pulses, capillary refill, movement, and sensation. To prevent hip dislocation, ensure that he or she does not flex the hips beyond 90 degrees The length of stay in the acute care hospital is typically 3 days Teach Patient: Teach patient to keep from flexing hips more than 90 degrees and should use high chairs to sit on and walkers to move around. Nursing Diagnosis: Impaired physical mobility r/t musculoskeletal impairment and surgery - Before activity, observe for and, if possible, treat pain with massage, heat pack to affected area, or medication. Ensure that the client is not oversedated.

- Help the client achieve mobility and start walking as soon as possible if not contraindicated. Risk for injury r/t altered mobility