The client has a deep partial-thickness injury to the posterior neck. Which intervention is most important to use during the acute phase to prevent contractures associated with this injury?
A. Place a towel roll under the client’s neck or shoulder.
B. Keep the client in a supine position without the use of pillows.
C. Have the client turn the head from side to side 90 degrees every hour while awake.
D. Keep the client in a semi-Fowler’s position and actively raise the arms above the head every hour while awake.
Correct Answer: C. Have the client turn the head from side to side 90 degrees every hour while awake.
The function that would be disrupted by a contracture to the posterior neck is flexion. Moving the head from side to side prevents such a loss of flexion. Deformities and contractures can often be prevented by proper positioning. Maintaining proper body alignment when the patient is in bed is vital. This movement is what would prevent contractures from occurring.
Option A: Placing a towel roll under the neck might not help prevent contractures. Immobilization is only allowed when a part of the body has just been grafted. Even then, the area must be kept in an antideformity position.
Option B: The client should not only be in a supine position but there should be a movement to avoid contractures. Splinting and proper positioning will also help achieve the prevention of contractures. As a matter of importance, movement should be incorporated into the patient’s daily routine from their inception to the hospital.
Option D: The burns are in the client’s posterior neck. Performing active or passive range of motion (ROM) exercises, depending on the patient’s level of consciousness is crucial in the prevention of these complications.
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