A patient with lumbar surgery must be moved using the following technique?

IGNOU Post B. SC. Nursing entrance -2021

Medical & Surgical Nursing

Easy

Appeared in: IGNOU Post B. SC. Nursing entrance -2021

Explanation

Log rolling is a specific maneuver designed to move a patient while maintaining the spinal column in a straight, neutral alignment.
This technique is critical for patients who have had spinal surgery or sustained a spinal injury to prevent any twisting, flexion, or extension that could damage the spinal cord or surgical repair.
The patient's body is moved as a single unit, with the head, shoulders, and hips turning simultaneously, as if they were a log.
A pillow is placed between the knees to prevent tension on the spinal column and adduction of the hips during the turn.

Option B: Raising the patient's legs would cause flexion at the hips and in the lumbar spine. This movement places direct stress on the area of the lumbar surgery, which is strictly contraindicated.
Option C: Extending the head would cause hyperextension of the cervical spine and disrupt the neutral alignment of the entire spinal column. The head must be kept in a neutral position, in line with the torso.
Option D: This describes a destination or position in the bed, not a movement technique. While moving a patient closer to the side rail is a common action, the critical part of the question is how to perform the movement safely, which requires log rolling.

Clinical Relevance

Nursing practice connection: Use the key finding related to Safe patient handling and positioning after spinal surgery to guide bedside assessment, documentation, and the next nursing action.
Mastering the log rolling technique is a fundamental competency for nurses to ensure patient safety and prevent devastating secondary injuries, particularly in orthopedic, neurosurgery, and trauma units.
Effective log rolling requires clear communication and teamwork. One person must take the lead (usually the person stabilizing the head) and coordinate the turn with a clear count.
What if? If a patient with a spinal precaution needs to be moved and there are not enough staff members available (minimum of 2-3), the nurse must not attempt the move. The correct action is to call for assistance. Attempting to move the patient alone or with insufficient help risks severe injury to both the patient and the nurse.

How to Approach the Question

First, identify the key clinical context in the question: 'lumbar surgery'. This immediately signals that the spine is vulnerable and must be protected.
Next, understand the goal: the question asks for a 'technique' to 'move' the patient. The core principle for moving a post-spinal surgery patient is maintaining neutral alignment.
Evaluate each option against this principle:
Does 'log rolling' maintain alignment? Yes, that is its specific purpose.
Does raising legs maintain alignment? No, it causes flexion.
Does extending the head maintain alignment? No, it causes hyperextension and misalignment.

Concept Tested & Keywords

Concept Tested: Safe patient handling and positioning after spinal surgery.
Stem keywords: lumbar surgery, moved, technique
Lead-in keywords: must be moved using
Clinical cues: The phrase 'lumbar surgery' is the primary clinical cue, indicating a need for strict spinal precautions to prevent injury.

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E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 166-168

E6 Nursing Fundamentals Taylor p. 359-361