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Question

Difficulty: MediumBasic Care and Comfort

An older adult client is recovering in the ambulatory care unit immediately following the surgical removal of a cataract in the right eye. To promote optimal comfort and prevent an increase in intraocular pressure, which positioning intervention should the practical nurse implement?

  1. Adjust the bed to a Semi-Fowler's position and assist the client to rest on their left side or back.Answer
  2. B
    Keep the client resting completely flat with only a small cervical roll for support.
  3. C
    Assist the client to roll onto their right side and support the back with a wedge pillow.
  4. D
    Guide the client into a prone posture with their head turned away from the surgical site.

Answer

Adjust the bed to a Semi-Fowler's position and assist the client to rest on their left side or back.
Following cataract surgery, it is critical to prevent an increase in intraocular pressure. Adjusting the bed to a Semi-Fowler's position (head elevated 30 to 45 degrees) promotes venous drainage from the head, which naturally lowers pressure. Additionally, positioning the client either supine or on the non-operative side (the left side, since the right eye was operated on) prevents direct mechanical pressure on the delicate surgical site.

Step-by-Step Solution

1
Identify the surgical procedure and the affected side.
The client had a cataract removed from the right eye.
Knowing the operative side is essential for determining safe postoperative positioning and preventing direct pressure.
2
Determine the physiological goals following eye surgery.
The primary goals are to prevent an increase in intraocular pressure (IOP) and avoid direct physical contact with the surgical site.
Increased IOP or direct pressure can cause hemorrhage or disrupt the surgical incision, leading to severe complications.
3
Select the position that achieves these goals.
A Semi-Fowler's position facilitates venous drainage, and resting on the back or non-operative (left) side avoids direct pressure on the right eye.
This specific combination of bed elevation and side-lying protects the surgical eye while promoting comfort and safety.

Key Concept

Postoperative Positioning for Eye Surgery
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Topics

Basic Care and Comfort

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