Long-Term Care

Trainer’s tip: General restorative care for residents after hip surgery

LTC Nursing Assistant Trainer, April 8, 2010

Residents who are admitted or readmitted following hip repair or replacement surgery may need special hip precautions until the operative site has fully healed. If hip precautions are not ordered on admission, contact the physician to determine whether they are necessary. If so, list the resident-specific hip precautions on the care plan and flow sheet(s). The physician will specify how long the resident must avoid weight-bearing after surgery. Some residents are able to ambulate with a walker soon after surgery. However, some physicians do not permit full weight-bearing for as long as four to six weeks. Make sure to clarify the ambulation and weight-bearing orders. If the physician does not order therapy, inquire whether physical and occupational therapy evaluations are needed. Restorative care of a resident after hip surgery includes:

  • Range-of-motion (ROM) exercises on the unaffected extremities
  • Turning and repositioning
  • Coughing and deep breathing exercises if the resident is bedfast
  • Assisting the resident to use the incentive spirometer every four hours, or as ordered
  • Pressure ulcer prevention (apply a pressure-reducing mattress to the bed, use pillows to elevate the heels in order to prevent heel ulcers, and apply a bed cradle to relieve downward pressure from the bed linen on the feet)
  • Checking the resident’s skin (particularly the heels) for signs of red or open areas
  • Assisting the resident with using the continuous passive motion machine to improve ROM if ordered

This is an excerpt from the HCPro book, The Long-Term Care Nursing Desk Reference, Second Edition, by Barbara Acello, MS, RN.

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