Which action should the nurse take when repositioning the patient who has just had a laminectomy and discectomy?
Instruct the patient to move the legs before turning the rest of the body.
Place a pillow between the patient's legs and turn the entire body as a unit.
Turn the patient's head and shoulders first, followed by the hips, legs, and feet.
Have the patient turn by grasping the side rails and pulling the shoulders over.
The Correct Answer is B
Choice A rationale
Moving the legs independently before turning can strain the spine and disrupt the surgical site. It does not ensure spinal alignment, which is critical after a laminectomy and discectomy to promote healing and prevent complications.
Choice B rationale
Placing a pillow between the legs and turning the body as a unit maintains spinal alignment, reducing stress on the surgical site. This technique, known as logrolling, ensures the spine remains stable during movement.
Choice C rationale
Turning the head and shoulders first, followed by the hips, legs, and feet, can result in twisting of the spine, which could compromise the surgical site and delay healing. It is not recommended.
Choice D rationale
Using side rails for movement requires significant upper body strength and may cause twisting of the spine, which is contraindicated post-spinal surgery. This method poses a risk of disrupting the surgical repair.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Administering 1 mg of glucagon intramuscularly stimulates glycogenolysis in the liver, increasing blood glucose levels. However, it is slower in onset compared to IV dextrose, which is critical in a non-arousable patient with a dangerously low blood glucose level of 50 mg/dL. Time efficiency is vital in this emergency.
Choice B rationale
Administering 25 g of dextrose IV pushes glucose directly into the bloodstream, providing an immediate increase in blood glucose. This is the most appropriate action for a non-arousable, hypoglycemic patient. Normal blood glucose ranges between 70-100 mg/dL fasting, making this an emergency requiring prompt correction.
Choice C rationale
Encouraging the patient to eat may be effective in mild hypoglycemia, but not for a critically low level like 50 mg/dL in a non-arousable patient. This delay can result in prolonged neuroglycopenic effects, worsening the patient’s condition.
Choice D rationale
Administering 7 units of Humalog insulin would worsen the hypoglycemia by facilitating glucose uptake into cells, which is contraindicated in this situation. Instead, glucose administration is required to correct the hypoglycemia immediately.
Correct Answer is ["A","B","D"]
Explanation
Choice A rationale
Keeping the patient NPO minimizes gastrointestinal motility and prevents further accumulation of intestinal contents, reducing the risk of perforation and worsening obstruction. Bowel rest is crucial in promoting resolution.
Choice B rationale
Nasogastric tube placement alleviates distention by decompressing the stomach and removing gastric contents, reducing vomiting and the risk of aspiration while improving patient comfort.
Choice C rationale
Rectal tubes are not effective in decompressing small bowel obstructions since the obstruction prevents material from reaching the rectum.
Choice D rationale
Frequent oral care prevents mucosal dryness and infection risk in patients who are NPO and receiving suction therapy, promoting overall oral hygiene.
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