Mrs. SIA 83 years old has to be sent back to long term care facility after replacement of her left hip. On the day of discharge she complains of pain. On assessment the left leg was shorter and foot turned inward. What should the nurse do?

• A. Reassure patient and discharge
• B. Apply traction
• C. Encourage patient to walk
• D. Call physician and request discharge to be cancelled

Answer: (D)

Recognize signs of a possible hip dislocation after a hip replacement and respond with urgent medical assessment. If a patient who just had a hip arthroplasty reports pain and the leg appears shorter with the foot rotated inward, this pattern strongly suggests dislocation of the prosthesis. That situation is an emergency: delaying evaluation can lead to nerve or blood vessel injury, avascular necrosis, and worse outcomes.

The appropriate action is to involve the physician immediately to evaluate for dislocation, obtain imaging, and determine the need for reduction in an appropriate setting. Discharging the patient at this moment would be unsafe. While awaiting care, continue to minimize movement and follow orders for immobilization and neurovascular checks, but the central priority is arranging timely medical management and keeping the patient in a setting where reduction or further treatment can be performed.