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Difficulty: Very hardBasic Care and Comfort

A practical nurse (PN) is preparing to provide a bed bath and linen change for a client on the second post-operative day following a right-sided pneumonectomy. The client is currently resting in a semi-Fowler's position and reports mild incisional stiffness. Which action is the most appropriate for the PN to implement to safely complete these basic care tasks?

  1. Maintain the head of the bed elevated and gently turn the client toward the right side to wash the back and replace the linens.Answer
  2. B
    Carefully roll the client onto the left lateral position to relieve pressure on the surgical incision during the bath.
  3. C
    Lower the head of the bed completely flat so the client can be easily rolled from side to side without sheer force.
  4. D
    Assign the entire procedure to an unlicensed assistive personnel with instructions to closely monitor the client's oxygen saturation.

Answer

The most appropriate action is to maintain the head of the bed elevated and gently turn the client toward the right side to wash the back and replace the linens.
Following a pneumonectomy, the most critical positioning principle is to place the client on their back or on the operative side (in this scenario, the right side). This ensures that the single remaining functional lung is entirely unrestricted and can expand optimally to maintain adequate gas exchange. Maintaining the head of the bed elevated further supports respiratory mechanics while safely providing basic hygiene.

Step-by-Step Solution

1
Identify the surgical procedure and its specific physiological implications.
The client had a right-sided pneumonectomy, meaning the right lung was completely removed and only the left lung remains functional.
Understanding the anatomy alters standard turning protocols during basic hygiene care.
2
Determine the correct post-operative positioning rules for a pneumonectomy.
Clients must be positioned on their back (supine) or on their operative side (right side in this case).
Positioning on the operative side ensures the fluid fills the empty surgical space and allows the remaining lung (left) to fully expand without restriction.
3
Evaluate the options against safe basic care principles.
Turning to the right side with the head elevated is the only safe option that maintains respiratory status while allowing access for hygiene.
It aligns with both basic comfort measures and strict post-operative safety guidelines.

Key Concept

Post-Pneumonectomy Positioning and Basic Care Integration
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Topics

Basic Care and Comfort

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