A patient being discharged after a hip replacement reports pain and notes the leg appears shorter. What is the appropriate action for the nurse?

• A. Cancel discharge and call the physician.
• B. Schedule a follow-up appointment after discharge.
• C. Proceed with discharge and arrange home care later.
• D. Have the patient rest and monitor symptoms at home.

Answer: (A)

The situation points to a potential hip prosthesis dislocation, which after hip replacement is a medical emergency requiring prompt physician assessment. Pain and the leg appearing shorter are classic signs that the joint may be out of place, and delaying evaluation can lead to serious complications such as damage to surrounding nerves, blood vessels, or the blood supply to the femoral head.

The correct action is to cancel discharge and contact the physician right away for urgent evaluation and management. While waiting for orders, keep the leg as stable as possible, avoid moving the hip (no flexion, adduction, or internal rotation), and perform ongoing neurovascular checks of the leg (color, warmth, pulses, movement, sensation) to monitor for changes. The physician will determine the need for imaging and whether reduction or surgical intervention is required in a controlled setting.

Options that involve sending the patient home or delaying evaluation would miss a critical, time-sensitive complication, and are not appropriate given these symptoms.