NURSING DIAGNOSIS: Pain: hip

related to tissue trauma and reflex muscle spasms associated with the surgery, blood accumulation and edema in surgical area, and improper positioning of the operative extremity.

Desired Outcome
The client will experience diminished hip pain (see Standardized Postoperative Care Plan, Diagnosis 6, for outcome criteria).
Nursing Actions and Selected Purposes/Rationales
  1. Refer to Standardized Postoperative Care Plan, Diagnosis 6, for measures related to assessment and reduction of pain.
  2. Implement additional measures to reduce pain:
    1. keep operative extremity in an abducted position (some physicians ensure this position by placing the extremity in balanced suspension for 24 hours after surgery; others order placement of an abduction wedge or 2-3 pillows between legs at all times)
    2. maintain restrictions on the degree of hip flexion as ordered (a 45-60° maximum may be ordered for first 2-3 days with a maximum of 90° during rehabilitation period)
    3. place trochanter roll or sandbag against the operative site for first 24-48 hours after surgery (pressure on the operative area helps maintain alignment and prevent hematoma formation)
    4. maintain patency of wound drainage system (e.g. prevent kinking of tubing, empty collection device as needed, keep collection device below surgical wound, maintain suction as ordered) to reduce accumulation of fluid in surgical area
    5. move operative extremity gently
    6. if turning is allowed, keep pillows between legs when turning and while in side-lying position to prevent adduction and resultant strain on surgical site
    7. apply ice to operative hip if ordered
    8. administer prescribed analgesics before exercise and ambulation sessions.