The nurse caring for a client with a fractured third cervical ...

[abern]

The nurse caring for a client with a fractured third cervical vertebrae determines the client is in spinal shock. Which bed position is the most appropriate for this client?
 
  1. Flat
  2. Semi-Fowler's
  3. Trendelenburg
  4. Reverse Trendelenburg

Question 2

The nurse is caring for a client in respiratory distress. Which bed position is the most appropriate for this client?
 
  1. Semi-Fowler's position
  2. Trendelenburg position
  3. Flat position
  4. Fowler's position

[memslove]

Answer to Question 1

Correct Answer: 1

A client with a fractured cervical vertebra must be maintained in a flat position to prevent any movement of the neck. Placing the client into the Trendelenburg position, which would normally be indicated for a client in shock, would put this client at risk for further damage to the spinal cord. Semi-Fowler's position is contraindicated due to the client's spinal injury, and the reverse Trendelenburg position is contraindicated due to the client's diagnosis of spinal shock.

Answer to Question 2

Correct Answer: 4

The client with respiratory distress will breathe more easily if the bed is placed in the Fowler's position, because it reduces the compression of the abdominal contents into the stomach and allows for full lung expansion. Semi-Fowler's position is the best choice if Fowler's position is not possible due to the client's condition, but is not as good as Fowler's because it still allows some intrusion of abdominal contents into the diaphragm and limits full excursion. Trendelenburg position would be contraindicated because this causes abdominal organs to press into the diaphragm. Flat is also contraindicated, and will increase the client's respiratory distress.