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Difficulty: MediumBasic Care and Comfort

A nurse is caring for a client who returned to the medical-surgical unit one hour ago following a diagnostic cardiac catheterization via the right femoral artery approach. The client reports mild lower back discomfort and requests a change in position. Which of the following positioning interventions is most appropriate for this client?

  1. Maintain the client on bed rest with the head of the bed elevated no more than 30 degrees and the right leg kept straight.Answer
  2. B
    Elevate the head of the bed to a high Fowler's position to promote optimal lung expansion and back comfort.
  3. C
    Place a thick pillow directly under the right knee to slightly flex the joint and relieve tension on the lower back.
  4. D
    Turn the client onto the right side with both hips and knees flexed into a fetal position.

Answer

Maintain the client on bed rest with the head of the bed elevated no more than 30 degrees and the right leg kept straight.
Following a cardiac catheterization via the femoral artery, it is critical to keep the affected extremity straight to prevent bleeding and hematoma formation at the puncture site. Clients are typically maintained on strict bed rest for several hours post-procedure. The head of the bed may usually be elevated up to 30 degrees to provide some comfort, such as relieving lower back strain, and to facilitate eating or drinking without causing excessive flexion at the groin.

Step-by-Step Solution

1
Identify the procedure and the anatomical site of vascular access.
The client underwent a cardiac catheterization utilizing the right femoral artery.
The specific location of the arterial puncture dictates the required post-procedure mobility restrictions.
2
Determine the primary physiological risk associated with this specific access site.
The primary immediate risk is arterial hemorrhage or hematoma formation at the femoral access site.
The femoral artery is a major vessel under high pressure, making clot stability essential for hemostasis.
3
Select the positioning intervention that minimizes pressure and flexion on the affected groin area while addressing comfort.
Keeping the leg straight and limiting head elevation to a maximum of 30 degrees prevents harmful hip flexion.
Any significant bending of the hip can stretch or compress the puncture site, disrupting the clot. A 30-degree elevation is safe and helps alleviate lower back discomfort.

Key Concept

Post-procedure positioning for femoral artery access
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Topics

Basic Care and Comfort

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