Examkin

Question

Difficulty: HardBasic Care and Comfort

Following a right eye retinal detachment repair utilizing an intraocular gas bubble injection (pneumatic retinopexy), a client is transferred to the surgical unit. The provider's prescriptions specify strict positioning to ensure the gas bubble maintains continuous contact with the posterior retina. Which of the following positions should the practical nurse assist the client to maintain?

  1. A prone position in bed or seated with the head resting face-down on a padded overbed table.Answer
  2. B
    A supine position with the head of the bed elevated 30 to 45 degrees.
  3. C
    A right lateral recumbent position with a soft pillow supporting the operative side.
  4. D
    A high-Fowler's position with the neck slightly extended backward to reduce intraocular pressure.

Answer

The correct action is to assist the client into a face-down (prone) position or have them sit leaning forward with their head resting face-down.
Because an intraocular gas bubble floats upward, the client must be maintained in a face-down (prone) position. This specific orientation makes the posterior aspect of the eye the highest point, allowing the buoyant gas to rise and maintain continuous pressure against the posterior retina to promote reattachment.

Step-by-Step Solution

1
Analyze the therapeutic purpose of the intraocular gas bubble in the clinical scenario.
The gas bubble is injected to apply pressure (tamponade) to the torn or detached retina on the posterior aspect of the eye, holding it in place while it heals.
Understanding the physical goal of the procedure is essential for determining the correct nursing intervention for positioning.
2
Apply the basic principles of physics regarding gas buoyancy to the client's anatomy.
Because gas is lighter than intraocular fluid, the bubble will always float upward. Therefore, the target area (the posterior retina) must be oriented as the highest point of the eye.
Physiological positioning must align with gravitational forces to ensure the treatment is effective.
3
Evaluate the provided positioning options to find which one makes the back of the eye the highest point.
A prone (face-down) position rotates the eyeball so the posterior aspect faces upward, ensuring the buoyant gas bubble floats up and presses directly against the targeted surgical site.
Positions like supine, lateral, or high-Fowler's would cause the bubble to float to the front, side, or top of the eye respectively, rendering the procedure ineffective and potentially causing harm.

Key Concept

Postoperative basic care and positioning following pneumatic retinopexy requires strict face-down (prone) positioning to utilize gas buoyancy to tamponade the posterior retina.
Estimated Time:1m 30s
Rate this question

Topics

Basic Care and Comfort

More questions from this topic