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Difficulty: MediumBasic Care and Comfort

A practical nurse is caring for a client who is 12 hours postoperative following a total thyroidectomy. The client reports neck discomfort and requests assistance with repositioning. Which action is most appropriate for the nurse to take?

  1. Maintain the client in a semi-Fowler's position and support the head and neck.Answer
  2. B
    Lower the head of the bed to a flat position to relieve tension on the incision.
  3. C
    Offer oral fluids immediately to help soothe the reported throat discomfort.
  4. D
    Delegate the task of repositioning the client's head to the assistive personnel.

Answer

The nurse should maintain the client in a semi-Fowler's position and support the head and neck.
The correct action demonstrates appropriate postoperative positioning for comfort and safety. Elevating the head of the bed to a semi-Fowler's position decreases swelling and promotes optimal lung expansion. Supporting the head and neck with pillows or sandbags maintains a neutral alignment, avoiding tension or pulling on the surgical sutures.

Step-by-Step Solution

1
Identify the surgical procedure and its specific risks.
The client had a total thyroidectomy, which carries high risks for airway compromise, neck edema, and strain on the suture line.
Understanding the anatomical risks dictates safe basic care and comfort measures.
2
Determine the optimal positioning for this specific postoperative client.
The semi-Fowler's position (head of bed elevated 30-45 degrees) with careful neck support in a neutral position is required.
Elevation reduces swelling and facilitates respiratory effort, while support prevents hyperextension of the neck.
3
Evaluate the remaining options for safety violations.
Flat positioning worsens edema; delegating to assistive personnel is unsafe due to the need for strict alignment; and giving fluids ignores airway safety protocols.
Distractors represent common procedural and prioritization errors in postoperative basic care.

Key Concept

Postoperative Basic Care and Positioning
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Topics

Basic Care and Comfort

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