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Difficulty: HardBasic Care and Comfort

A practical nurse is caring for a client who underwent a diagnostic cardiac catheterization via the right femoral artery 2 hours ago. The client is on prescribed strict bed rest and reports intense lower back discomfort from lying completely flat. Which action should the practical nurse take to promote the client's comfort?

  1. A
    Elevate the head of the bed to a 45-degree angle to decrease muscle tension on the lumbar spine.
  2. B
    Instruct the client to actively bend both knees and place their feet flat on the mattress.
  3. Assist the client to turn onto their left side while maintaining the right leg in a straight, neutral position.Answer
  4. D
    Place a firm pillow directly under the client's right knee to slightly flex the joint and reduce back strain.

Answer

The correct intervention is to assist the client to turn onto their left side while maintaining the right leg in a straight, neutral position.
Following a femoral cardiac catheterization, the affected extremity must remain completely straight to prevent disruption of the arterial clot and subsequent bleeding or hematoma formation. Turning the client onto the unaffected (left) side while keeping the affected (right) leg straight is an effective comfort measure that relieves pressure on the lumbar spine without compromising the insertion site.

Step-by-Step Solution

1
Identify the critical post-procedure constraints for a femoral cardiac catheterization.
The client must remain on bed rest with the affected leg (right leg) completely straight and immobilized.
Arterial punctures are under high pressure, and flexing the hip can dislodge the clot, causing a hematoma or hemorrhage.
2
Evaluate the client's request for back pain relief against these safety constraints.
The client needs a position change that relieves lumbar pressure without flexing the right hip.
Lying completely flat causes muscle tension in the lower back, requiring a safe nursing intervention for comfort.
3
Determine the safest basic care positioning intervention.
Turning the client to the unaffected (left) side while keeping the right leg extended is the best approach.
This shifts body weight off the sacrum and lumbar spine while maintaining the required straight alignment of the femoral insertion site.

Key Concept

Safe positioning and comfort measures following femoral artery access
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Topics

Basic Care and Comfort

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