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A total hip joint replacement takes approximately two to four hours
of surgical time. The preparation prior to surgery may take
additional hours. After surgery, the patient is taken to a recovery
room for immediate observation which generally lasts between one to
four hours. The lower extremities will be closely observed for both
adequate sensation and circulation. If unusual symptoms of numbness
or tingling are noted by the patient, recovery room nurses are
available and should be notified by the patient. Upon stabilization,
the patient is transferred to a hospital room.
During the immediate recovery period, patients are given intravenous
fluids. Intravenous fluids are important to maintain a patient's
electrolytes as well as for administering antibiotics. Patients also
will notice tubes draining fluid from the surgical wound site. The
amount and character of the drainage is important to the doctor and
can be monitored closely by the nurse in attendance. A dressing is
applied in the operating room and will remain in place for two to
four days to be later changed by the attending surgeon and staff.
Pain control medications are commonly given through a
patient-controlled analgesia (PCA) pump whereby patients can
actually administer their own dose of medications on demand. Pain
medications occasionally can cause nausea and vomiting. Anti-nausea
medications may then be given.
Measures are taken to prevent blood clots in the lower extremities.
Patients are placed in elastic hose (TEDs) after surgery.
Compression stockings are often added which act by squeezing with
circulating air in plastic bags wrapped around the legs, forcing
blood circulation. Patients are encouraged to actively exercise the
lower extremities in order to mobilize venous blood in the lower
extremities to prevent blood clots. Medications are often given to
thin the blood in order to further prevent blood clots.
Patients may also experience difficulty with urination. This
difficulty can be a side effect of medications given for pain. As a
result, catheters are often placed into the bladder to allow normal
passage of urine.
Immediately after surgery, patients are encouraged to frequently
perform deep breathing and coughing in order to avoid lung
congestion and the collapse of tiny airways in the lungs. Patients
are also given a "blow bottle," whereby active blowing against
resistance maintains the opening of the breathing passages.
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