A nurse is preparing to turn a client who is obese following a spinal fusion. The nurse should plan to use which of the following techniques to turn this client?

Choice A reason: Unlike Chickenpox, the Vesicles of Smallpox Are More Abundant on the Face

This statement indicates an understanding of the teaching. Smallpox lesions are indeed more abundant on the face and extremities compared to chickenpox, which tends to have a more central distribution on the trunk. Smallpox lesions are also typically more uniform in their stage of development, whereas chickenpox lesions can appear in various stages of healing simultaneously.

Choice B reason: Smallpox Lesions Appear in Various Stages of Healing

This statement is incorrect. Unlike chickenpox, where lesions can be in different stages of healing at the same time, smallpox lesions generally progress through the same stages simultaneously. This uniformity in lesion development is a distinguishing feature of smallpox.

Choice C reason: Vaccination Against Smallpox Provides Lifelong Immunity

This statement is partially correct but needs clarification. The smallpox vaccine provides long-lasting immunity, but it may not be lifelong. Immunity can wane over time, and booster vaccinations may be necessary for continued protection.

Choice D reason: There Are Rare, Occasional Occurrences of Smallpox

This statement is incorrect. Smallpox was declared eradicated in 1980 by the World Health Organization (WHO). There have been no naturally occurring cases of smallpox since then. The only known stocks of the virus are kept in secure laboratories for research purposes.

The client is at risk for developing Pneumonia, Deep vein thrombosis, and Pressure ulcers

Choice A: Pneumonia

Reason: Postoperative patients, especially those who have undergone abdominal surgery, are at a higher risk of developing pneumonia. This is due to the fact that pain and discomfort can prevent them from taking deep breaths and coughing effectively, which are essential actions to clear the lungs of secretions. The nurse’s notes indicate that the client is refusing to turn and cough due to pain, which further increases the risk of pneumonia. The use of splinting with a pillow when coughing is a technique to help reduce pain and encourage effective coughing, but if the client refuses to comply, the risk remains high.

Choice B: Deep Vein Thrombosis (DVT)

Reason: Deep vein thrombosis is a significant risk for postoperative patients, particularly those who are immobile. The client in this scenario has refused to wear intermittent pneumatic compression devices, which are designed to prevent DVT by promoting blood circulation in the legs. Immobility and the lack of these devices increase the risk of blood clots forming in the deep veins of the legs. If a clot forms and travels to the lungs, it can cause a life-threatening pulmonary embolism. The nurse’s notes emphasize the importance of these devices, but the client’s refusal to use them puts them at a higher risk of developing DVT.

Choice C: Pressure Ulcers

Reason: Pressure ulcers, also known as bedsores, are a common complication for patients who are immobile for extended periods. The client’s refusal to change positions increases the risk of pressure ulcers developing on areas of the body that are in constant contact with the bed. These ulcers can be painful and lead to serious infections if not managed properly. Regular turning and repositioning are crucial in preventing pressure ulcers, and the nurse’s notes highlight the importance of this practice.

Choice D: Urinary Retention

Reason: While urinary retention can be a postoperative complication, it is less likely in this scenario because the client has a Foley catheter in place, which is draining to a bedside bag. The catheter helps to ensure that the bladder is emptied regularly, reducing the risk of urinary retention. Therefore, this is not one of the primary risks for this client based on the provided information.

Choice E: Hemorrhage

Reason: Hemorrhage, or excessive bleeding, is a potential risk after any surgery, including a total abdominal hysterectomy. However, the nurse’s notes indicate that the abdominal dressing is dry and intact, and only scant vaginal bleeding has been observed. This suggests that there is no significant bleeding at this time. While hemorrhage is always a concern, the current observations do not indicate an immediate risk.