Author Question: According to the posterior surgical approach, there are two main goals for maintaining proper ... (Read 83 times)

jilianpiloj · **on:** Jun 25, 2018

According to the posterior surgical approach, there are two main goals for maintaining
proper alignment of S.P.'s operative leg. What are they, and how are they achieved?

What will be an ideal response?

Question 2

How will you monitor for excessive postoperative blood loss?

What will be an ideal response?

patma1981 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Extremes of internal rotation must be avoided. Abduction of the hip should be maintained by
using pillows or an abduction pillow splint between S.P.'s legs. Pillows are also placed bilaterally
under calves. It is important to prevent adduction of the hip.
Extreme flexion of the hip is avoided by elevating the head of bed (HOB) no more than 45 degrees
on the first postoperative night until after the PT evaluation. The HOB can be elevated to 60
degrees after the patient gets out of bed the next morning.

Answer to Question 2

Observe amount of drainage on the dressing.
Monitor VS according to orders or the hospital protocol. The protocol might be VS q15min for
1 hour, q30min for 1 hour, then hourly for 4 hours, then every 4 hours. Assess VS for signs of
hemorrhage: decreased blood pressure (BP), increased pulse, and increased respiratory rate;
monitoring the trend over time is especially important.
Monitor hemoglobin (Hgb) and hematocrit (Hct) levels.
Send stools to the laboratory forhemoccult testing on stools X 3 . This is important because the
patient is receiving warfarin and enoxaparin.
Observe for bleeding from other areas, such as nose and gums, and blood in urine and for
excessive bruising.
Observe for unusual swelling and discoloration of the surgical site.
Monitor level of consciousness (LOC), restlessness, and pain.