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Difficulty: HardBasic Care and Comfort

An adult client is transferred to the medical-surgical unit immediately following a diagnostic cardiac catheterization performed via a right femoral artery approach. The client reports mild lower back pain and requests a change in position to relieve the discomfort. Which action by the practical nurse is the most appropriate to ensure the client's safety and comfort?

  1. A
    Elevate the head of the bed to a 60-degree angle to shift the client's body weight off the lumbar spine.
  2. B
    Place a large, rolled towel directly under the right knee to provide joint support and relieve back tension.
  3. C
    Assist the client to turn onto the left side and bring both knees toward the chest to stretch the lower back.
  4. Maintain the client in a supine position with the head of the bed elevated no more than 15 degrees, keeping the right leg completely straight.Answer

Answer

The practical nurse should maintain the client in a supine position with the head of the bed elevated no more than 15 degrees and the affected right leg completely straight.
Following a cardiac catheterization via the femoral artery, the client must remain strictly on bed rest in a supine position for several hours. The affected extremity must be kept completely straight to prevent tension or bending at the groin, which could dislodge the clot and precipitate severe arterial bleeding. A slight elevation of the head of the bed (usually 15 to 30 degrees maximum) is permissible for basic comfort, but the right hip must remain extended at all times.

Step-by-Step Solution

1
Assess the client's request for repositioning against post-procedure safety requirements.
The client had a right femoral artery puncture, which carries a high risk of arterial hemorrhage if the site is stressed.
Identifying the procedure access site dictates strict positioning limitations that supersede routine comfort measures.
2
Determine which comfort measures do not compromise the arterial puncture site.
Any flexion of the right hip or right knee is strictly contraindicated.
Flexion puts stress on the arterial access site, which can dislodge the internal clot and cause severe, life-threatening bleeding.
3
Implement a safe positioning strategy that balances safety with basic comfort.
The client is kept flat, or elevated minimally (under 30 degrees), with the affected leg completely extended.
This position maintains continuous, even pressure on the femoral site and prevents arterial bleeding while providing some positional relief for the back.

Key Concept

Post-Cardiac Catheterization Positioning (Femoral Approach)
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Topics

Basic Care and Comfort

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