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Difficulty: EasyBasic Care and Comfort

A practical nurse is assigned to care for a client who is two hours postoperative following a subtotal thyroidectomy. To minimize swelling and protect the surgical airway, which position is most appropriate for the nurse to place the client in?

  1. Semi-Fowler's position with pillows supporting the head and neckAnswer
  2. B
    Supine position with a small rolled towel placed directly under the shoulders
  3. C
    High-Fowler's position with the neck flexed so the chin rests near the chest
  4. D
    Left lateral recumbent position with the head resting flat on the mattress

Answer

Semi-Fowler's position with pillows supporting the head and neck
The correct action is to place the client in a Semi-Fowler's position while providing support to the head and neck. Elevating the head of the bed 30 to 45 degrees utilizes gravity to reduce postoperative swelling and venous pressure in the neck region. Supporting the head and neck with pillows ensures they remain in a neutral alignment, which prevents both flexion and hyperextension. This neutral positioning protects the surgical incision from tension, reduces pain, and ensures the airway remains fully open.

Step-by-Step Solution

1
Identify the surgical procedure and its specific postoperative risks.
The client underwent a thyroidectomy, which carries high risks of neck edema, airway obstruction, and incision strain.
Understanding the anatomical risks dictates the appropriate basic care and positioning required for safety.
2
Determine the ideal bed angle to manage these specific risks.
The head of the bed should be elevated 30 to 45 degrees, known as Semi-Fowler's position.
Elevation uses gravity to reduce venous pressure, minimizing fluid accumulation and swelling in the delicate neck area.
3
Select the appropriate support method for the affected body part.
The head and neck must be supported in a neutral position using pillows or sandbags.
Maintaining neutral alignment prevents both hyperextension and hyperflexion, avoiding any tension on the fragile suture line.

Key Concept

Postoperative Positioning for Airway Protection
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Topics

Basic Care and Comfort

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