An 8-year-old boy is returned to his room following a tonsillectomy. He remains sleepy from the anesthesia but is easily awakened. The nurse should place the child in which of the following positions?
A. Sims'
B. Side-lying
C. Supine
D. Prone
Correct Answer: B. Side-lying
Side-lying position is most effective to facilitate drainage of secretions from the mouth and pharynx; reduces possibility of airway obstruction. At home, the patient needs to take complete rest and only get up to go to the toilet, but that too with assistance. It is advised that the patient lies with his or her head elevated to a point where the operated site is higher than the heart. This will reduce the risk of swelling and edema. In case of swelling, an ice pack applied to the neck may help.
Option A: Sims’ position is on side with top knee flexed and thigh drawn up to chest and lower knee less sharply flexed: used for vaginal or rectal examination. Sims’ position or semi prone position is when the patient assumes a posture halfway between the lateral and the prone positions. The lower arm is positioned behind the client, and the upper arm is flexed at the shoulder and the elbow. The upper leg is more acutely flexed at both the hip and the knee, than is the lower one.
Option C: Supine position increases risk for aspiration, would not facilitate drainage of oral secretions. Supine position, or dorsal recumbent, is wherein the patient lies flat on the back with head and shoulders slightly elevated using a pillow unless contraindicated (e.g., spinal anesthesia, spinal surgery).
Option D: Prone position can develop airway obstruction and aspiration, unable to observe the child for signs of bleeding such as increased swallowing. In a prone position, the patient lies on the abdomen with head turned to one side and the hips are not flexed. Prone position is often used for neurosurgery, in most neck and spine surgeries.
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