Matching the home to hip precautions
After a posterior-approach total hip arthroplasty, the client must avoid hip flexion beyond 90°, adduction across the midline, and internal rotation until the capsule heals. The son reports a squat-type toilet and low stools, which both force deep hip flexion. The best discharge plan replaces low, deep-flexion surfaces with a raised toilet seat or commode and a firm chair with armrests, arranged and taught before discharge. Option 2 provides both items and keeps every daily activity within safe hip flexion.
Why each item is chosen
A raised toilet seat (or a commode set over the toilet) lifts the sitting surface so the hips stay above the knees. A firm chair with armrests of adequate height lets the client sit without sinking and push up with her arms rather than leaning forward from the hips. Because the family usually sits on low stools, the nurse identifies one suitable chair she will use at home. The family is taught the precautions, how to help her sit and stand, and how to arrange the bathroom.
Checking each option against the 90° rule
Every option includes one correct item, so the deciding question is whether both items keep flexion below 90°.
| Option | First item | Second item | Safe overall? |
|---|
| 1 | Bedside commode: acceptable | Low padded sofa: flexes hip beyond 90° | No |
| 2 | Raised toilet seat: safe | Firm armchair: safe | Yes |
| 3 | Squat toilet with grab bar: flexes far beyond 90° | Firm armchair: safe | No |
| 4 | Raised toilet seat: safe | Low stool for bathing: flexes beyond 90° | No |
Watch out! A grab bar helps balance but does not change the depth of a squat. And a soft, low sofa is doubly risky: the client sinks into flexion and then leans forward to rise.
Culturally sensitive teaching
Squat toilets, low stools, and floor sitting are common in many households. The nurse respects these practices while explaining why they are unsafe for the next weeks, offers practical substitutes, and checks that the equipment is available before discharge. Other aids include a long-handled reacher, sock aid, and long-handled sponge so she does not bend forward. Key point! After posterior hip replacement, avoid squatting, low seats, and floor sitting; plan a raised toilet seat and a firm chair with armrests before discharge.