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Question

Difficulty: MediumBasic Care and Comfort

During an afternoon shift on a long-term care unit, a resident who underwent a left-eye cataract removal earlier that morning asks for help getting comfortable in bed. Which positioning technique should the practical nurse use for this resident?

  1. Elevate the head of the bed to 30 degrees and position the resident on their right side.Answer
  2. B
    Lower the head of the bed completely flat and place a single pillow under the resident's head.
  3. C
    Assist the resident to roll onto their left side with a wedge pillow placed behind their back.
  4. D
    Guide the resident into a prone position to decrease environmental light stimulation to the eyes.

Answer

The correct strategy is to elevate the head of the bed to 30 degrees and position the resident on their right side (the unoperated side).
Following cataract surgery, the primary goal of positioning is to prevent an increase in intraocular pressure (IOP) and to protect the surgical site from physical trauma. Elevating the head of the bed to at least 30 degrees (Semi-Fowler's position) promotes venous drainage from the head, which naturally reduces IOP. Furthermore, positioning the client on the unoperated (right) side prevents direct weight and pressure from being applied to the healing surgical (left) eye.

Step-by-Step Solution

1
Identify the surgical procedure and the affected side.
The client had a left-eye cataract removal.
Determining the operative side is essential to avoid placing pressure on the surgical site during rest.
2
Determine the primary physiological goal for positioning this client.
The goal is to prevent any increase in intraocular pressure (IOP) and protect the operative eye from injury.
Increased IOP can rupture the surgical incision, leading to vision loss and severe complications.
3
Select the position that meets these criteria while promoting comfort.
A Semi-Fowler's position on the non-operative (right) side or directly on the back is appropriate.
Elevating the head promotes venous drainage from the head, naturally lowering IOP, while avoiding the left side prevents accidental trauma to the healing eye.

Key Concept

Postoperative Positioning for Cataract Surgery
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Topics

Basic Care and Comfort

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