A nurse is caring for a client who had a right sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take?

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.

Choice A reason: Occasional bubbling in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Occasional bubbling in the water seal chamber occurs when the client exhales, coughs, or sneezes, and it shows that air is being removed from the pleural space.

Choice B reason: Continuous bubbling in the water seal chamber. This finding indicates that the client is experiencing a complication because it suggests that there is an air leak in the chest tube system. An air leak can prevent the lung from expanding and cause respiratory distress.

Choice C reason: Fluctuations in the fluid level in the water seal chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Fluctuations in the fluid level in the water seal chamber occur when the client breathes, and they show that the pressure in the pleural space is changing.

Choice D reason: Constant bubbling in the suction control chamber. This finding does not indicate that the client is experiencing a complication, but rather that the chest tube is functioning properly. Constant bubbling in the suction control chamber occurs when the suction source is connected, and it shows that the suction is working.