N2261: Total Hip Replacement/ Total Hip
Arthroplasty Answered Correctly 2025!!!!
Osteoarthritis CORRECT ANSWERS - chronic, progressive joint disease
- most common joint disease
- primary cause is unknown
- secondary causes may be due to trauma (ex: sports injury), metabolic disease,
decreased oestrogen production following menopause, overuse (ex: running), infection,
joint instability, being overweight or obese
Osteoarthritis CORRECT ANSWERS Patients may wait months before coming in to see
their physician. The pain is what brings them in and the swelling can be intense
Symptoms:
- pain (may be slow progression of localized pain)
- stiffness and swelling around the joint(s) lasting > 2 weeks
- limitation of joint movement (stiffness)
- crepitus (grating sound caused by bone rubbing against bone)
- may effect any joint in body (ex: spine, knees, hips, hands, and shoulders etc)
Osteoarthritis CORRECT ANSWERS Diagnostics:
- rheumatoid factor (to eliminate the possibility of RA)
- erythrocyte sedimentation rate (ESR), which is the gross measure of inflammation
- C-reactive protein
- bone scan (radioactive nucleotide is injected 60 minutes prior to scan; radioactive dye
is picked up on scan in bone that is fractured or porus, callused or weak)
- Dual X-Ray Absorptionmetry (DXA): scan for osteoporosis; important to conduct prior
to a hip replacement to determine whether the femur is strong enough to support the
prosthetic (determines areas of porousness)
Osteoarthritis CORRECT ANSWERS Treatment:
- heat/cold (preference or physician, client and physio)
- protect joints
- avoid heavy lifting, use proper body mechanics, grab bars and assistive devices
(braces and canes)
- weight loss
- pain management is key (NSAIDs and tylenol)
- use of glucosamine and chondroitin
- steroid injections
Hip Fracture CORRECT ANSWERS - common causes are falls and major trauma (ex:
MVA)
, - risk factors include age, chronic medical conditions (ex: A. fib, HTN, TIA - diseases
that make patients light-headed and dizzy, putting them at risk for fall), being female,
nutrition (ex: diet ), physical inactivity, tobacco/alcohol use; medications (ex:
corticosteroids), environmental hazards (ex: mats, extension cords, clutter)
- diagnosed by x-ray, physical exam, CT scan, ESR, RF, DXA scan
Hip Fracture CORRECT ANSWERS - fractures occur commonly the femoral neck (ex:
intertrochanteric, subtrochanteric, subcapital, transcervical)
- where fracture is will influence type of prosthetic used (unipolar, cementless,
intramedullary nailing - doing whatever supports bone the best)
- based on age, co-morbidities and physical condition
Hip Fracture CORRECT ANSWERS Manifestation:
- external rotation
- muscle spasm causing shortened extremity
- pain and tenderness
- unable to use limb or walk
- displaced femoral neck fracture can cause serious interruption of blood supply leading
to avascular necrosis
Hip Fracture CORRECT ANSWERS Treatment:
- Total Hip Replacement (THR) or Total Hip Athroscopy (THA); reconstruction or
replacement of joint to relieve pain, to improve ROM or to correct a deformity
- THR/THA usually lasts for 10-15 years in most individuals
Hip Fracture CORRECT ANSWERS Pre-Operative Nursing Care
- assessment
- consent and prep re: hospital policy
- NPO at least 8 hours prior
- bed rest and frequent tipping/turning
- Foley catheter
- pain, nausea and constipation management
- teach post-op mobility restrictions
- pillow between knees when in bed
- hips cannot be lower than knees
- do not cross legs (ankles or knees)
- raised toilet seat to avoid 90 degree limit of hips
- don't reach in bed for items, use a grabbing device
- maintain proper hip and pelvic alignment
- don't bend over, use sock puller or shoe horn
Total Hip Arthroplasty CORRECT ANSWERS - under general anaesthetic or spinal
anaesthesia
- incision over hip and down thigh
- head of femur removed
Arthroplasty Answered Correctly 2025!!!!
Osteoarthritis CORRECT ANSWERS - chronic, progressive joint disease
- most common joint disease
- primary cause is unknown
- secondary causes may be due to trauma (ex: sports injury), metabolic disease,
decreased oestrogen production following menopause, overuse (ex: running), infection,
joint instability, being overweight or obese
Osteoarthritis CORRECT ANSWERS Patients may wait months before coming in to see
their physician. The pain is what brings them in and the swelling can be intense
Symptoms:
- pain (may be slow progression of localized pain)
- stiffness and swelling around the joint(s) lasting > 2 weeks
- limitation of joint movement (stiffness)
- crepitus (grating sound caused by bone rubbing against bone)
- may effect any joint in body (ex: spine, knees, hips, hands, and shoulders etc)
Osteoarthritis CORRECT ANSWERS Diagnostics:
- rheumatoid factor (to eliminate the possibility of RA)
- erythrocyte sedimentation rate (ESR), which is the gross measure of inflammation
- C-reactive protein
- bone scan (radioactive nucleotide is injected 60 minutes prior to scan; radioactive dye
is picked up on scan in bone that is fractured or porus, callused or weak)
- Dual X-Ray Absorptionmetry (DXA): scan for osteoporosis; important to conduct prior
to a hip replacement to determine whether the femur is strong enough to support the
prosthetic (determines areas of porousness)
Osteoarthritis CORRECT ANSWERS Treatment:
- heat/cold (preference or physician, client and physio)
- protect joints
- avoid heavy lifting, use proper body mechanics, grab bars and assistive devices
(braces and canes)
- weight loss
- pain management is key (NSAIDs and tylenol)
- use of glucosamine and chondroitin
- steroid injections
Hip Fracture CORRECT ANSWERS - common causes are falls and major trauma (ex:
MVA)
, - risk factors include age, chronic medical conditions (ex: A. fib, HTN, TIA - diseases
that make patients light-headed and dizzy, putting them at risk for fall), being female,
nutrition (ex: diet ), physical inactivity, tobacco/alcohol use; medications (ex:
corticosteroids), environmental hazards (ex: mats, extension cords, clutter)
- diagnosed by x-ray, physical exam, CT scan, ESR, RF, DXA scan
Hip Fracture CORRECT ANSWERS - fractures occur commonly the femoral neck (ex:
intertrochanteric, subtrochanteric, subcapital, transcervical)
- where fracture is will influence type of prosthetic used (unipolar, cementless,
intramedullary nailing - doing whatever supports bone the best)
- based on age, co-morbidities and physical condition
Hip Fracture CORRECT ANSWERS Manifestation:
- external rotation
- muscle spasm causing shortened extremity
- pain and tenderness
- unable to use limb or walk
- displaced femoral neck fracture can cause serious interruption of blood supply leading
to avascular necrosis
Hip Fracture CORRECT ANSWERS Treatment:
- Total Hip Replacement (THR) or Total Hip Athroscopy (THA); reconstruction or
replacement of joint to relieve pain, to improve ROM or to correct a deformity
- THR/THA usually lasts for 10-15 years in most individuals
Hip Fracture CORRECT ANSWERS Pre-Operative Nursing Care
- assessment
- consent and prep re: hospital policy
- NPO at least 8 hours prior
- bed rest and frequent tipping/turning
- Foley catheter
- pain, nausea and constipation management
- teach post-op mobility restrictions
- pillow between knees when in bed
- hips cannot be lower than knees
- do not cross legs (ankles or knees)
- raised toilet seat to avoid 90 degree limit of hips
- don't reach in bed for items, use a grabbing device
- maintain proper hip and pelvic alignment
- don't bend over, use sock puller or shoe horn
Total Hip Arthroplasty CORRECT ANSWERS - under general anaesthetic or spinal
anaesthesia
- incision over hip and down thigh
- head of femur removed
