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Zorluk: OrtaBasic Care and Comfort

An adult client is admitted to the telemetry unit immediately following a diagnostic cardiac catheterization using the right femoral artery approach. Which basic care and comfort measures should the practical nurse (PN) implement? Select all that apply.

  1. Restrict the backrest elevation to a maximum of 30 degrees.Cevap
  2. Instruct the client to keep the affected lower extremity perfectly straight.Cevap
  3. Provide a fracture bedpan to assist with elimination needs without excessive movement.Cevap
  4. D
    Position a folded blanket beneath the right knee to ease lower back strain.
  5. E
    Reposition the client into a side-lying posture every two hours to protect the sacral skin.

Cevap

The correct interventions are restricting the backrest elevation, instructing the client to keep the affected leg straight, and using a fracture bedpan.
The correct basic care interventions prioritize minimizing mechanical stress on the femoral artery puncture site to prevent life-threatening hemorrhage. Restricting the backrest elevation to a maximum of 30 degrees, maintaining strict leg straightness, and utilizing a low-profile fracture bedpan all successfully address the client's basic comfort and elimination needs without causing dangerous hip flexion.

Adım Adım Çözüm

1
Identify the client's procedure and specific anatomical access site.
The client underwent a cardiac catheterization via the right femoral artery.
Different access sites (e.g., radial vs. femoral) require entirely different postoperative mobility and comfort restrictions.
2
Determine the primary physiological risk associated with the femoral approach.
The greatest immediate risk is arterial hemorrhage or hematoma formation at the groin puncture site.
The femoral artery is a major vessel under high pressure; any disruption of the clotting process can lead to rapid blood loss.
3
Evaluate each comfort and care measure against the need to protect the access site.
Measures that keep the hip flat and straight (low backrest, straight leg, flat bedpan) are safe. Measures that flex the hip (knee pillows, side-lying) are unsafe.
Hip flexion places mechanical stress directly on the femoral artery, potentially dislodging the newly formed clot.

Anahtar Kavram

Post-procedure positioning and mobility restrictions for femoral access
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Konular

Basic Care and Comfort

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