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Difficulty: MediumBasic Care and Comfort

A client is admitted to the surgical unit directly from the recovery room after undergoing a subtotal thyroidectomy. To promote optimal comfort and prevent postoperative complications, which positioning strategy should the practical nurse implement?

  1. Place the client in a semi-Fowler's position and arrange supportive pillows on both sides of the neck.Answer
  2. B
    Keep the mattress completely flat and assist the client into a lateral decubitus position.
  3. C
    Position the client supine with a small rolled towel situated beneath the shoulder blades.
  4. D
    Adjust the bed into a high-Fowler's position and encourage the client to rest their chin on their chest.

Answer

Place the client in a semi-Fowler's position and arrange supportive pillows on both sides of the neck.
Following a thyroidectomy, it is critical to prevent swelling around the trachea and to avoid stressing the incision line. Placing the client in a semi-Fowler's position uses gravity to minimize venous pooling and edema in the neck. Surrounding the head and neck with supportive pillows maintains neutral alignment, preventing both hyperflexion and hyperextension, thereby protecting the airway and the integrity of the sutures.

Step-by-Step Solution

1
Identify the anatomical location of the surgical procedure and its associated risks.
The client had a subtotal thyroidectomy, which carries high risks for airway obstruction due to neck edema and incision rupture from tension.
Understanding the surgical site dictates the required basic care and positioning.
2
Evaluate how gravity and body alignment affect the surgical site.
An upright or semi-upright position uses gravity to reduce swelling, while neutral neck alignment prevents pulling on the sutures.
Edema near the trachea can quickly cut off the airway, making swelling reduction the top physiological priority.
3
Select the positioning intervention that best achieves both comfort and safety.
Semi-Fowler's position with lateral head support achieves both reduced edema and neutral neck alignment.
This directly satisfies the requirement for optimal postoperative positioning following neck surgery.

Key Concept

Postoperative care for thyroidectomy requires minimizing neck edema and preventing tension on the surgical incision through specific upright, neutral body alignment.
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Topics

Basic Care and Comfort

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