How soon post op do you turn your total hip replacement pattients?

  1. Just curious what the rest of you ortho nurses do? Do you reposition and then let them go back to the back or do you turn them and leave them on the unop side for a period of time?

    Is it possible by not turing them you could cause a nerve injury?

    Thanks
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  2. 21 Comments

  3. by   P_RN
    Q 2h back to unop side. SOME docs will allow partial turn to operative side if an abduction wedge is used. I'm not so concerned about nerve damage as I am about atalectasis, pneumaona and skin impairment.
  4. by   brinasmommy27
    I agree with you...what I am asking you is how soon after they come to the post op floor do you turn them? Do you do it as soon as 2 hours or do you wait a little while? v
  5. by   P_RN
    No we turn them after about 1 hr from PACU. That's usually when they are more comfortable and family has slowed down on their visiting. It would also depend on whether you needed to check the epidural site or the dressing again...maybe sooner if there's a problem there.
  6. by   ga.bones
    We also turn a couple of hours out of PACU.
  7. by   Keysnurse2008
    Our facility now does most of their total hips via lap.a very small incision, decreases their LOS and reduces their post op complications.Our fresh post op pts have abduction pillows in place and are not turned for the few hours /or night of surgery.The next day...like within 12 hours PT has them up walking.Just like any other surgical patient the worst thing they can do is become immobile .the quicker you can get them OOB the faster the recovery.we maintain hip alignment during hours of sleep with an abduction pillow and ambulate with PT asap.
  8. by   jax
    I haven't seen THR done via laproscope - sounds great. Curious as to what is the average length of stay? Are hemi-arthroplastys open or done via laproscope?

    Thanks for any replies. Jax
  9. by   KimRN03
    We turn once pain is controlled, then q 2 hrs.
  10. by   mjamesRN
    Directly received from PACU, and as long as pain is controlled and an Abductor pillow is in place, you should be able to turn your patient -- carefully of course -- you have to tuen them usually anyway to remove excess linens and listen to lung sounds.
  11. by   meownsmile
    We can turn straight from PACU if we want or need to. As long as the BP is stable and pain is controlled we let them go to position of comfort for them. Unaffected side only where i work. If i were to really watch the clock on it, it would probly be more like 2 hours though, because by the time we get them settled, assessed, get them some PO liquids, maybe a bedpan, and family has assured themselves it is at least that long.
  12. by   ocicat
    Why not turn them? What are you afraid of? After all you can always turn them back.
    Seriously, the sooner you get them to understand that turning is important the better.
  13. by   ocicat
    The main nerve injury is usually the peroneal nerve and that has to do with where the abductor straps are placed and if they are too tight.
  14. by   adidas99
    Quote from ocicat
    The main nerve injury is usually the peroneal nerve and that has to do with where the abductor straps are placed and if they are too tight.
    I work on a surgical care unit..and we get TONS of orthos... Hips we sometims turn as soon as we lock the bed(or pull them off the stretcher).Just prop them with alot of pillows for support. It simply depends on whether they complain their back aches or whatever. helps alot with pain relief, too, even if they dont complain of their back aching. Other than that, q2 to unop side, then on back q2, etc.

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