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Difficulty: MediumBasic Care and Comfort

An older adult client is resting in the surgical unit following a left cataract extraction. The client reports mild postoperative discomfort and asks to be repositioned in bed. Which positioning strategy should the licensed practical nurse implement?

  1. A
    Turn the client to a left side-lying position to promote drainage from the affected eye.
  2. B
    Lower the head of the bed to a completely flat position to promote venous return and ensure spinal alignment.
  3. Elevate the head of the bed 30∘30^\circ to 45∘45^\circ and assist the client into a supine or right side-lying position.Answer
  4. D
    Instruct the client to bend forward at the waist while shifting their lower body to find a comfortable position.

Answer

Elevate the head of the bed 30 to 45 degrees and assist the client into a supine or right side-lying position.
Following cataract extraction, it is critical to prevent increases in intraocular pressure (IOP) while providing comfort. Elevating the head of the bed 30∘30^\circ to 45∘45^\circ and placing the client either supine or on the non-operative side (the right side, in this case) achieves optimal comfort while protecting the surgical site from undue pressure.

Step-by-Step Solution

1
Identify the client's surgical procedure and the affected side.
The client underwent a left cataract extraction.
Determining the exact operative side is essential for selecting a safe position that avoids direct pressure on the surgical site.
2
Determine the primary postoperative goal for basic care and comfort following eye surgery.
The primary goal is to prevent any increase in intraocular pressure (IOP) while keeping the client comfortable.
Increased IOP can cause bleeding, suture rupture, or permanent vision loss in the operated eye.
3
Evaluate the positioning options against the goal of maintaining low IOP.
Elevating the head of the bed (30 to 45 degrees) and positioning the client on the non-operative (right) side or supine safely achieves this goal.
Lying flat, lying on the operative side, or bending at the waist all increase IOP and are incorrect comfort measures.

Key Concept

Postoperative Positioning and Comfort Care for Cataract Surgery
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Topics

Basic Care and Comfort

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