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Question

Difficulty: EasyBasic Care and Comfort

A practical nurse is caring for a client who recently returned to the unit following a subtotal thyroidectomy. To promote comfort, minimize neck swelling, and support the airway, which of the following positions should the nurse assist the client into?

  1. A
    Supine position with the bed completely flat
  2. Semi-Fowler's position with pillows supporting the head and neckAnswer
  3. C
    Left lateral Sims' position with the head of the bed flat
  4. D
    Prone position with a small pillow placed under the chest

Answer

The correct position is Semi-Fowler's position with pillows supporting the head and neck.
Elevating the head of the bed to a Semi-Fowler's position (30 to 45 degrees) and carefully supporting the head and neck with pillows promotes venous return. This directly decreases postoperative swelling in the neck area and prevents dangerous tension on the incision line, ensuring a patent airway and maximizing client comfort.

Step-by-Step Solution

1
Identify the client's surgical procedure and related risks.
The client had a thyroidectomy (neck surgery), which carries a high risk of airway compromise due to postoperative tissue swelling and bleeding.
Understanding the procedure dictates the specific comfort and safety interventions required.
2
Evaluate the physiological effects of different body positions on the head and neck.
Elevating the head of the bed uses gravity to promote venous drainage away from the surgical site, while keeping the bed flat increases pressure and fluid accumulation.
Decreasing fluid accumulation in the neck prevents airway compression and promotes overall comfort.
3
Select the position that optimally meets the client's postoperative needs.
Semi-Fowler's position (head of bed elevated 30-45 degrees) with neck support is chosen.
This specific position achieves optimal venous return, minimizes tension on the sensitive suture line, and keeps the airway clear.

Key Concept

Postoperative Positioning for Neck Surgery
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Topics

Basic Care and Comfort

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