The nurse is assigned to care for a client who had a total hip replacement an hour ago. Which of the following should the nurse assess first?

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Common complications following total hip replacement are bleeding, prosthesis dislocation, deep vein thrombosis, and infection. Total joint replacements carry a risk of serious blood loss; therefore, the nurse should check the drainage device and dressing frequently to monitor blood loss, especially during the first several postoperative hours. (Option B) Pain is typically controlled via a patient-controlled analgesia device with a programmed dosage and lockout. The client's level of pain should be assessed, but assessing for hemorrhage is the priority. (Option C) Following total hip replacement, the client will have an abduction pillow between the legs to prevent adduction of the affected leg. Adduction of the leg could potentiate dislocation of the prosthesis. It is important that the client not flex the affected hip more than 90 degrees, as this could dislocate the prosthesis. Therefore, the client should be provided elevated toilet seats and chairs that do not recline. The nurse should assess for signs of hip dislocation, including shortening and internal rotation of the leg. Although providing an abduction pillow is important, assessing for hemorrhage is the priority. (Option D) Assessment of the urine in a postoperative client's catheter bag is important but is not priority in this situation. Educational objective: Orthopedic surgeries, particularly total hip replacement, can cause significant blood loss. Assessing the dressing and drainage device is a priority over positioning an abduction pillow and evaluating the client's pain and quality of urine.

The Nurse Is Assigned to Care for a Client Who