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Zorluk: ZorBasic Care and Comfort

A practical nurse is caring for a client who is 24 hours postoperative following a right-sided pneumonectomy for lung cancer. The client is currently in a supine position and states, "My back aches from lying flat. Can you help me turn onto my side?" Which of the following actions should the nurse take?

  1. Turn the client onto their right side and elevate the head of the bed to a semi-Fowler's position.Cevap
  2. B
    Assist the client to turn onto their left side and place a support pillow behind their back.
  3. C
    Advise the client to remain flat in the supine position and administer a prescribed PRN analgesic.
  4. D
    Help the client into a prone position for 15 minutes to completely relieve pressure on the dorsal spine.

Cevap

Turn the client onto their right side and elevate the head of the bed to a semi-Fowler's position.
Following a pneumonectomy, positioning the client on the operative side (the right side in this scenario) or supine is correct because it promotes full expansion and ventilation of the remaining functional lung. This positioning also uses gravity to keep the mediastinal structures in their proper midline position, preventing them from shifting into the empty pleural space, which could severely compromise cardiac output and respiratory status.

Adım Adım Çözüm

1
Assess the specific surgical procedure the client underwent.
The client had a right-sided pneumonectomy (complete removal of the right lung).
Identifying the specific type of surgery is crucial because thoracic procedures, particularly lung removal, require unique and specific positioning precautions.
2
Evaluate the requested nursing intervention against physiological principles.
The client wants to turn on their side. Turning to the unoperated side (left) would compress the remaining functional lung.
Gravity and fluid shifts can compromise the single functioning lung and cause mediastinal structures to shift into the empty surgical space if positioned improperly.
3
Select the safest position to promote comfort and physiological stability.
Position the client on their right side (operative side) with the head of the bed elevated.
This relieves back pressure, maximizes the ventilation of the healthy left lung, and prevents mediastinal shift.

Anahtar Kavram

Postoperative Positioning: Pneumonectomy
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Konular

Basic Care and Comfort

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