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Difficulty: MediumBasic Care and Comfort

A practical nurse is caring for a 6-year-old child who has just returned to the pediatric unit following a tonsillectomy. The child is currently sleeping but arouses easily to verbal stimuli. Which position is the safest and most appropriate for the nurse to place this client in?

  1. A
    Supine with the head of the bed elevated to a high-Fowler's position
  2. Partially prone or side-lying with the head turned to one sideAnswer
  3. C
    Flat on the back with a rolled towel placed under the shoulders
  4. D
    On the back with the foot of the bed elevated above the head

Answer

The safest and most appropriate position is partially prone or side-lying with the head turned to one side.
Following a tonsillectomy, clients who are not fully awake should be placed in a side-lying or partially prone position. This alignment uses gravity to naturally drain blood and oral secretions out of the mouth rather than down the throat, thereby maintaining a clear airway and preventing aspiration.

Step-by-Step Solution

1
Identify the client's surgical procedure and current level of consciousness.
The client had a tonsillectomy and is currently drowsy and sleeping.
Postoperative tonsillectomy clients are at high risk for bleeding and aspiration of secretions, especially when not fully awake.
2
Determine the primary goal of positioning for this specific client.
The primary goal is to maintain a patent airway by allowing blood and oral secretions to drain out of the mouth.
Airway maintenance is always the highest priority in postoperative care (ABC prioritization).
3
Evaluate the positioning options against the primary goal.
A side-lying or partially prone position allows gravity to drain fluids from the mouth, whereas supine positions encourage fluids to pool in the back of the throat.
Gravity-assisted drainage minimizes the risk of choking and aspiration in a client who cannot independently clear their own airway.

Key Concept

Postoperative Airway Management and Positioning
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Topics

Basic Care and Comfort

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