This comfort device is used to support hips and thighs, preventing external rotation and keeping the feet in alignment in case of paralysis, fracture of femur and hip surgery?

1. A

   Trochanter roll

2. B

   Sand bags

3. C

   Bed boards

4. D

   Bed block

Appeared in: SJH Nursing Officer - 2019

Explanation

• A trochanter roll is specifically designed to counter the effect of gravity that causes an immobile patient's leg to rotate outwards.
• It is made by rolling a sheet or blanket and tucking it snugly along the lateral aspect of the thigh, from the greater trochanter of the femur down to the knee.
• This provides a physical barrier that maintains the femur in a neutral position, keeping the toes pointing towards the ceiling.
• This device is essential for preventing external rotation contractures in patients with prolonged bed rest.

Why Other Options Were Wrong

• Option B: Sandbags are used for general immobilization or to apply weight. They are not the primary or most effective device for specifically preventing hip rotation and can increase the risk of pressure injuries due to their weight and lack of breathability.
• Option C: Bed boards are placed under the mattress to provide a firmer foundation for the entire bed. They support the patient's back and improve spinal alignment but have no direct effect on positioning the hips or preventing rotation.
• Option D: Bed blocks are used to elevate the entire head or foot of the bed. They are used for systemic positioning (e.g., Trendelenburg or reverse Trendelenburg) and do not target a specific limb or joint.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Positioning and Comfort Devices as background academic context rather than a clinical decision trigger.
• Proper positioning is a fundamental nursing intervention to prevent complications of immobility, such as pressure ulcers, contractures, and nerve damage.
• Failure to prevent external hip rotation can lead to a permanent contracture, making it difficult for the patient to walk normally once they regain mobility.
• Nurses must regularly assess the skin integrity under the trochanter roll and ensure it is positioned correctly without causing excessive pressure.

How to Approach the Question

• First, identify the core problem described in the question stem: the need to prevent the hip from rotating outward.
• Next, analyze the provided image. Observe the rolled blanket placed alongside the thigh, physically blocking outward movement.
• Evaluate each option based on its primary function. A trochanter roll is for rotation, sandbags for weight/immobilization, bed boards for mattress support, and bed blocks for elevating the bed.
• Match the specific function from the question (preventing external rotation) with the device designed for that exact purpose.
• The combination of the descriptive text and the clear visual clue in the image strongly points to the trochanter roll as the correct answer.

Concept Tested & Keywords

• Concept Tested: Positioning and Comfort Devices
• Stem keywords: comfort device, support hips and thighs, preventing external rotation, alignment, paralysis, fracture of femur, hip surgery
• Lead-in keywords: This comfort device is used to
• Clinical cues: The clinical conditions mentioned (paralysis, femur fracture, hip surgery) all put a patient at high risk for immobility and subsequent musculoskeletal complications like external hip rotation.
• Negative lead-in flag: false

Question ID

QGhJaWWCrI-nqc01-gzNe

Copy ID

Reference Book

E6 Nursing Fundamentals Taylor p. 328-330

E6 Nursing Brunner Adult Health 3SA Vol 1 Part 4 p. 135-137