A nurse is serving on a committee that is developing infectious disease protocols. Which of the following instructions should the nurse include in the protocol for clients who have Clostridium difficile?

A. Use an air-assisted device.

Using an air-assisted device, such as a hover mat or air mattress, is an appropriate measure when repositioning a client with a pressure ulcer. These devices help reduce friction and shear forces, minimizing the risk of further skin breakdown. It also aids in maintaining the skin's integrity during movement, making it a suitable choice for the prevention of pressure ulcers.

B. Position the bed in reverse Trendelenburg:

Positioning the bed in reverse Trendelenburg involves raising the foot of the bed higher than the head. This position is not specifically related to pressure ulcer prevention or repositioning. It may be used for other medical reasons, but it does not directly address the issue of pressure ulcer care.

C. Elevate the head of bed to a 45° angle:

While elevating the head of the bed is commonly used for various reasons, including respiratory support or preventing aspiration, it may not be directly related to the repositioning of a client with a pressure ulcer. The angle mentioned (45°) is not specifically associated with pressure ulcer care.

D. Lower the bed close to the ground:

Lowering the bed close to the ground may be a safety measure to prevent injuries from falls, but it does not address the specific needs of repositioning a client with a pressure ulcer. The focus in pressure ulcer care is typically on using appropriate devices and techniques to minimize friction and pressure on vulnerable areas of the skin.

A. Repositioning the client by log-rolling is a critical intervention after lumbar laminectomy surgery. Log-rolling involves turning the entire body as a unit to prevent twisting or bending at the waist, which can strain the surgical site and potentially cause injury. This method helps protect the spine and maintain alignment during movement.

B. Placing a pillow under the client's back while supine is generally not recommended after a lumbar laminectomy. It may cause hyperextension of the spine, leading to discomfort and potential strain on the surgical site.

C. Removing the back brace when the client is out of bed is not a standard practice without specific orders from the surgeon. Back braces are often prescribed for support and stabilization during movement, especially in the early postoperative period.

D. Maintaining the head of the bed at 90° is not advisable after a lumbar laminectomy. The positioning of the bed should be individualized based on the surgeon's preferences, but typically, keeping the bed flat or in a slightly elevated position is more appropriate to reduce strain on the surgical site.