A nursing 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?
A.
Place the client in protective isolation.
B.
Initiate the use of a PCA pump for pain control.
C.
Keep the head of the bed at a 30° angle.
D.
Reposition the client by log rolling every-4 hr.
The Correct Answer and Explanation is:
The correct answer is D. Reposition the client by log rolling every 4 hours.
Explanation:
Postoperative care for adolescents following scoliosis repair with Harrington rod instrumentation is crucial for effective recovery and to prevent complications. This surgery involves the correction of spinal curvature through the insertion of metal rods, which necessitates specific postoperative interventions.
Log Rolling Technique:
- Purpose and Rationale:
- The use of the log rolling technique is essential in maintaining spinal alignment and preventing strain on the surgical site. This method involves rolling the patient as a single unit without twisting the spine, which helps in avoiding stress on the newly repaired spine and the implanted hardware.
- Since the Harrington rod instrumentation involves extensive manipulation of the spine, it is crucial to maintain the spine in a stable and aligned position to promote healing and prevent displacement of the rods or further injury.
- Implementation:
- Repositioning the patient every 4 hours using the log rolling technique ensures that pressure is evenly distributed, reducing the risk of pressure ulcers and promoting comfort. This also helps in mobilizing the patient safely and effectively, which is important for overall recovery and prevention of complications such as deep vein thrombosis (DVT).
Other Options:
- A. Place the client in protective isolation:
- Protective isolation is not generally required for postoperative scoliosis repair unless the patient is immunocompromised or has a specific infection risk. This intervention is not a standard part of the care plan for this surgery.
- B. Initiate the use of a PCA pump for pain control:
- While pain management is critical, the use of a Patient-Controlled Analgesia (PCA) pump is not always standard for every postoperative scoliosis repair. Pain control methods should be tailored to the individual patient’s needs and institutional protocols.
- C. Keep the head of the bed at a 30° angle:
- The head of the bed might be elevated to 30 degrees to help with respiratory function or comfort; however, this angle should be tailored to the surgeon’s specific instructions regarding spinal alignment and comfort for the patient. It is not a universal requirement.
In summary, log rolling every 4 hours is the most appropriate intervention to include in the care plan for an adolescent postoperative scoliosis repair with Harrington rod instrumentation. It is essential for maintaining spinal alignment, preventing complications, and promoting overall recovery.