A nurse is collecting data from a client who reports difficulty sleeping at night. Which of the following client statements indicates an understanding of sleep promotion?

Choice A Reason:

Supine is incorrect. The supine position (lying flat on the back) is not the best choice because it can increase the risk of airway obstruction and discomfort, especially if there is swelling or drainage from the surgical site.

Choice B Reason:

Left lateral is incorrect. The left lateral position (lying on the left side) is not typically used after a thyroidectomy because it does not provide the same advantages for airway management, swelling reduction, and comfort as the semi-Fowler's position.

Choice C Raeson:

Semi-Fowler's position is the most appropriate choice for a client who is postoperative following a subtotal thyroidectomy for several reasons:

Airway Management: Elevating the head of the bed in a semi-Fowler's position helps maintain airway patency and reduces the risk of airway obstruction or compression of the surgical site, which is important for respiratory comfort and function.

Swelling and Drainage: After thyroid surgery, there may be swelling and drainage from the surgical site. The semi-Fowler's position can assist in reducing swelling and facilitating proper drainage.

Comfort: This position generally provides greater comfort for the client, especially when there may be discomfort or soreness at the surgical site.

Choice D Reason:

Dorsal recumbent is incorrect. The dorsal recumbent position (lying on the back with knees flexed and feet flat on the bed) is also not the most appropriate choice for post-thyroidectomy care because it does not offer the same benefits as the semi-Fowler's position in terms of airway management, swelling reduction, and comfort.

Choice A Reason:

Telling the client to discuss the decision with her family implies that the family should influence or make the decision for the client. The decision to continue or discontinue treatment is a personal one that the client should make based on their own values and preferences.

Choice B Reason:

Supporting the client's decision to stop the treatment is correct. When a client with end-stage kidney disease decides to stop dialysis treatment, it's essential for the nurse to respect the client's autonomy and support their decision. The client has the right to make decisions about their own healthcare, including the decision to discontinue a treatment that is no longer aligned with their goals and wishes.

Choice C Reason:

Discussing alternative treatment methods may be appropriate in some cases, but if the client has made an informed decision to stop dialysis, the focus should be on respecting and supporting that decision rather than presenting alternatives.

Choice D Reason:

Involving the facility chaplain may be beneficial if the client desires spiritual or emotional support during this difficult decision-making process, but it should be at the client's request, not imposed by the nurse.