A nurse is planning care for an adolescent who is postoperative following scoliosis repair with Harrington rod instrumentation. Which of the following interventions should the nurse include in the plan of care?
Reposition the client by log rolling every 4 hr.
Place the client in protective isolation.
Keep the head of the bed at a 30° angle.
Initiate the use of a PCA pump for pain control.
The Correct Answer is D
a. Log rolling is an appropriate technique to reposition a postoperative scoliosis repair patient as it minimizes stress on the spine and helps maintain spinal alignment. Patients need frequent repositioning to prevent pressure ulcers and promote comfort, but every 4 hours may not be frequent enough; typically, every 2 hours is recommended.
b. Protective isolation is not typically required for patients undergoing scoliosis surgery unless they have specific risk factors for infection (e.g., immunocompromised status). Standard postoperative care focuses on monitoring for infection at the surgical site rather than isolation unless indicated by the patient's condition.
c. While it’s important to elevate the head of the bed to assist with breathing and comfort, after scoliosis surgery, the head of the bed is generally elevated to 30-45° to facilitate lung expansion and reduce the risk of aspiration. However, it should be ensured that this angle does not compromise spinal alignment, especially in the early postoperative period.
d. The use of a patient-controlled analgesia (PCA) pump is an appropriate intervention for pain management after scoliosis surgery. It allows the patient to self-administer pain medication within prescribed limits, leading to more effective pain management, improved patient satisfaction, and potentially reduced need for supplemental analgesics.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Hydroceles are common in newborns and often go away without treatment by age.
Choice A is not correct because a hydrocele is not a genetic condition and does not require genetic counseling.
Choice B is not correct because retracting the foreskin and cleansing it several times daily is not necessary for a hydrocele.
Choice C is not correct because surgery is not always necessary for a hydrocele; it often goes away on its own.
Correct Answer is A
Explanation
Isotretinoin has been associated with depression and other psychiatric side effects.
The client should report any changes in mood or behavior, including feelings of isolation, to the provider immediately.
Choice B is not an answer because while frequent nosebleeds can be a side
effect of isotretinoin, it is not the priority to report to the provider.
Choice C is not an answer because while back pain can be a side effect of isotretinoin, it is not the priority to report to the provider.
Choice D is not an answer because while itching of the skin can be a side effect of isotretinoin, it is not the priority to report to the provider.
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