A client who underwent a right-sided supratentorial craniotomy two days ago is currently receiving continuous enteral feedings via a nasogastric tube. The practical nurse is preparing to provide a complete bed bath and change the soiled bottom sheets. What is the safest method for the nurse to execute these care tasks?
- ALower the bed to a completely flat position to ensure the spine remains perfectly straight while the team log-rolls the client.
- BApply soft wrist restraints temporarily before starting the hygiene routine to prevent accidental dislodgment of the feeding tube.
- Maintain the bed at a 30-degree incline while turning the client laterally, ensuring the head and neck remain in a neutral midline alignment.Answer
- DPosition the client upright at a 90-degree angle and gently guide the chin toward the chest to gain adequate access to the posterior neck.
Answer
The practical nurse should maintain the head of the bed at a 30-degree elevation and keep the client's head and neck in a neutral, midline position while turning them.
Following a supratentorial craniotomy, it is critical to promote venous drainage from the brain to prevent life-threatening increases in intracranial pressure. This is achieved by keeping the head of the bed elevated at 30 to 45 degrees and ensuring the neck is not flexed or rotated. Additionally, because the client is receiving continuous enteral feedings, maintaining this elevation is mandatory to prevent regurgitation and pulmonary aspiration. Turning the client laterally while preserving this 30-degree incline and neutral neck alignment perfectly balances the client's hygiene needs with their strict neurological and respiratory safety requirements.
Step-by-Step Solution
Key Concept
Positioning principles for clients with increased intracranial pressure risk and continuous enteral feedings.