Page 2115 - Saunders Comprehensive Review For NCLEX-RN

D. Walker

1. Stand adjacent to the client on the affected side.
2. Instruct the client to put all 4 points of the walker flat
on the floor before putting weight on the hand pieces.
3. Instruct the client to move the walker forward,
followed by the affected or weaker foot and then the
unaffected foot.

Safety is the priority concern when the client uses an assistive

device such as a cane, walker, or crutches. Be sure that the client
demonstrates correct use of the device.
IX. Fractured Hip
A. Types
1. Intracapsular (femoral head is broken within the joint
capsule)
a. Femoral head and neck receive
decreased blood supply and heal
slowly.
b. Skin traction is applied preoperatively
to reduce the fracture and decrease
muscle spasms.
c. Treatment includes a total hip
replacement or open reduction internal
fixation (ORIF) with femoral head
replacement.
d. To prevent hip displacement
postoperatively, avoid extreme hip
flexion, and check the surgeon’s
prescriptions regarding positioning.
2. Extracapsular (fracture is outside the joint capsule)
a. Fracture can occur at the greater
trochanter or can be an
intertrochanteric fracture.
b. Preoperative treatment includes
balanced suspension or skin traction to
relieve muscle spasms and reduce
pain.
c. Surgical treatment includes ORIF with
nail plate, screws, pins, or wires.

B. Postoperative interventions

1. Monitor for signs of delirium and institute safety
measures.
2. Maintain leg and hip in proper alignment and prevent
internal or external rotation; avoid extreme hip

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