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OR Nurse:
doi: 10.1097/01.ORN.0000399840.44397.d4
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A quick guide to hip hemiarthroplasty

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INSTRUCTIONS A quick guide to hip hemiarthroplasty


* To take the test online, go to our secure Web site at

* On the print form, record your answers in the test answer section of the CE enrollment form on page 38. Each question has only one correct answer. You may make copies of these forms.

* Complete the registration information and course evaluation. Mail the completed form and registration fee of $21.95 to: Lippincott Williams & Wilkins, CE Group, 2710 Yorktowne Blvd., Brick, NJ 08723. We will mail your certificate in 4 to 6 weeks. For faster service, include a fax number and we will fax your certificate within 2 business days of receiving your enrollment form.

* You will receive your CE certificate of earned contact hours and an answer key to review your results.There is no minimum passing grade.

* Registration deadline is August 31, 2013.

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Lippincott Williams & Wilkins, publisher of ORNurse2011 journal, will award 2.3 contact hours for this continuing nursing education activity. Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

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A quick guide to hip hemiarthroplasty

GENERAL PURPOSE: To provide nurses with an overview of hip fractures and management of the patient undergoing hip hemiarthroplasty. LEARNING OBJECTIVES: After reading the preceding article and taking this test, you should be able to: 1. Identify preoperative considerations regarding hip fractures and hemiarthroplasty procedures. 2. Discuss intraoperative procedures and care during hemiarthroplasty. 3. Describe postoperative nursing care of the patient having hemiarthroplasty.

1. The primary risk factor for hip fracture is

a. gender.

b. age.

c. ethnicity.

d. lifestyle.

2. What percentage of hip arthroplasty patients die within 1 year of surgery?

a. 5% to 10%

b. 15% to 25%

c. 30% to 35%

d. 40% to 50%

3. Hemiarthroplasty is the surgery of choice for

a. patients with minimal ambulation.

b. high-functioning patients.

c. patients who walk for exercise.

d. acetabular fractures.

4. Older adults who fall are more like to sustain a hip fracture because they

a. fall forward.

b. fall backward.

c. fall on their side.

d. roll when they fall.

5. Preoperatively, the nurse should ensure that

a. the operative site has been shaved.

b. patient has had 5 days of antibiotic prophylaxis.

c. the patient is taking anticoagulants.

d. the operative site has been marked.

6. How many people should be involved with transferring the patient to the OR table?

a. one

b. two

c. three

d. four

7. One of the most common preventable causes of death related to orthopedic procedures is

a. pneumonia.

b. VTE.

c. disseminated intravascular coagulopathy.

d. surgical site infection.

8. Crucial to proper positioning for hip hemiarthroplasty is

a. the right lateral position.

b. a roll beneath the patient's shoulders.

c. maintaining body alignment.

d. flexing the head and neck.

9. When hair removal is required,

a. shave the patient the night before surgery.

b. shave the patient as close to the time of surgery as possible.

c. use clippers the night before surgery.

d. use clippers as close to the time of surgery as possible.

10. Primary responsibility for patient safety falls to the

a. perioperative RN.

b. scrub technician.

c. surgeon.

d. anesthesiologist.

11. Cementing of the femoral stem is indicated when

a. it will shorten the procedure time.

b. the implant is too large.

c. the patient's bone is severely osteopenic.

d. the patient is over 65.

12. An uncemented implant may be associated with

a. less thigh pain.

b. cardiorespiratory disturbances.

c. more intraoperative blood loss.

d. a higher risk of periprosthetic fracture.

13. As cement hardens, it can cause

a. vasodilation.

b. increased BP.

c. vasoconstriction.

d. an endothermic reaction.

14. The first closing sponge count is done

a. right before the prosthesis is implanted.

b. immediately following prosthesis implantation.

c. before closing the operative cavity.

d. before skin closure.

15. When moving the patient, don't let the hip

a. flex and rotate externally.

b. flex and rotate internally.

c. remain straight and rotate externally.

d. remain straight and rotate internally.

16. Placement of the abductor pillow and placement of a graduated compression stocking and sequential compression device on the operative leg are done

a. when first moved to the OR table.

b. after anesthesia induction but before the incision.

c. before moving off the OR table.

d. upon arrival in the PACU.

17. The patient who doesn't participate in early mobilization is at risk for

a. prosthesis dislocation.

b. pulmonary complications.

c. dehydration.

d. surgical site infection.

18. Tell patients to

a. sit with their knees together at all times.

b. cross their legs only at the ankles.

c. keep their knees higher than their hips when seated.

d. avoid flexing the hip when dressing.

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