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Question

Difficulty: EasyBasic Care and Comfort

A practical nurse is positioning a client in bed shortly after a thyroidectomy. Which of the following positions should the nurse use to promote client comfort and reduce the risk of complications?

  1. Semi-Fowler's position with pillows supporting the head and neckAnswer
  2. B
    Supine position with a small rolled towel under the shoulders to hyperextend the neck
  3. C
    Flat on the bed in a lateral side-lying position
  4. D
    Trendelenburg position with the head of the bed lowered

Answer

The most appropriate position is the semi-Fowler's position with pillows supporting the head and neck.
The semi-Fowler's position elevates the head, which utilizes gravity to help decrease surgical edema in the neck and facilitates easier breathing. Supporting the head and neck with pillows maintains neutral alignment, preventing tension on the suture line and reducing pain.

Step-by-Step Solution

1
Identify the surgical procedure and its anatomical location.
The client had a thyroidectomy, which involves an incision in the anterior neck.
Understanding the surgical site highlights the specific risks, primarily airway compromise from tissue edema and tension on the suture line.
2
Determine the physiological goal of postoperative positioning for this specific surgery.
The goal is to minimize swelling (edema) in the neck and protect the surgical incision from stretching.
Swelling in the neck can quickly lead to respiratory distress, and stretching the neck can tear the sutures.
3
Select the position that best achieves these goals.
Semi-Fowler's position uses gravity to reduce swelling, and supporting the head with pillows keeps the neck in a neutral position to avoid tension.
This combination effectively addresses the primary postoperative risks for neck surgery.

Key Concept

Postoperative Care and Positioning
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Topics

Basic Care and Comfort

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