A nurse in a critical care unit is caring for a client who is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

Prone

SemiFowler's

Sims

On the nonoperative side

Answer and Explanation

The Correct Answer is B

The correct answer is: d. On the nonoperative side

Choice A: Prone

Reason: Placing a patient in the prone position (lying face down) after a pneumonectomy is generally not recommended. This position can compromise respiratory function by restricting chest expansion and increasing the risk of respiratory complications. Additionally, it can place undue pressure on the surgical site, potentially leading to complications such as impaired wound healing or increased pain.

Choice B: Semi-Fowler’s

Reason: The Semi-Fowler’s position (head of the bed elevated to 30-45 degrees) is often used to promote lung expansion and reduce the risk of aspiration. While it can be beneficial for general postoperative care, it is not the optimal position for a patient who has undergone a pneumonectomy. This position does not specifically address the need to prevent fluid accumulation in the remaining lung.

Choice C: Sims

Reason: The Sims position (lying on the side with one leg bent) is typically used for procedures such as enemas or to facilitate drainage of oral secretions. It is not suitable for a postoperative pneumonectomy patient because it does not provide the necessary support to the remaining lung and can increase the risk of fluid shifting to the nonoperative side.

Choice D: On the nonoperative side

Reason: Placing the patient on the nonoperative side is the correct position. This position helps to prevent fluid from accumulating in the remaining lung and reduces the risk of complications such as mediastinal shift or respiratory distress. By positioning the patient on the nonoperative side, gravity helps to keep the remaining lung expanded and functional.

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Correct Answer is B

Explanation

Choice A reason: Placing food on the weaker side of the mouth when eating is not an effective strategy for a client who has dysphagia. This can increase the risk of choking or aspiration, as the food may not be chewed properly or may slip into the airway. The client should place food on the stronger side of the mouth and use the tongue to move it to the back of the throat for swallowing.

Choice B reason: Tilting the head forward when swallowing is an effective technique for a client who has dysphagia. This can help to close off the airway and prevent food or liquid from entering the lungs. The client should also tuck the chin down to the chest and swallow hard.

Choice C reason: Coughing while swallowing food is not a desirable outcome for a client who has dysphagia. This can indicate that the food is going into the wrong pipe and causing irritation or obstruction. The client should try to avoid coughing while swallowing and clear the throat after each bite or sip.

Choice D reason: Sitting at a 30° angle while eating meals is not a sufficient position for a client who has dysphagia. This can still allow food or liquid to flow back into the throat and cause choking or aspiration. The client should sit upright at a 90° angle and remain in that position for at least 30 minutes after eating.

A. Hyperthermia B. Absence of bowel sounds C. Polyuria D. Weakened gag reflex E. Hypotension

Correct Answer is ["B","D","E"]

Explanation

Choice A reason: Hyperthermia. This answer is incorrect because hyperthermia is not a complication of a cervical spinal cord injury, but rather a condition that can worsen the injury. Hyperthermia can increase the metabolic demand and oxygen consumption of the injured spinal cord, leading to more damage and inflammation.

Choice B reason: Absence of bowel sounds. This answer is correct because absence of bowel sounds is a complication of a cervical spinal cord injury, which can affect the autonomic nervous system and impair the function of the gastrointestinal system. A cervical spinal cord injury can cause spinal shock, which leads to decreased peristalsis and paralytic ileus.

Choice C reason: Polyuria. This answer is incorrect because polyuria is not a complication of a cervical spinal cord injury, but rather a condition that can occur after the resolution of spinal shock. Polyuria can result from the loss of sympathetic control over the renal system, leading to increased urine output and decreased antidiuretic hormone secretion.

Choice D reason: Weakened gag reflex. This answer is correct because weakened gag reflex is a complication of a cervical spinal cord injury, which can affect the autonomic nervous system and impair the function of the respiratory system. A cervical spinal cord injury can cause damage to the cranial nerves that control the gag reflex, leading to difficulty swallowing, aspiration, and pneumonia.

Choice E reason: Hypotension. This answer is correct because hypotension is a complication of a cervical spinal cord injury, which can affect the autonomic nervous system and impair the function of the cardiovascular system. A cervical spinal cord injury can cause neurogenic shock, which leads to decreased sympathetic tone, vasodilation, and reduced cardiac output.

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A nurse in a critical care unit is caring for a client who is postoperative following a right pneumonectomy. After extubation from the ventilator, in which of the following positions should the client be placed?

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