After lumber laminectomy nurses should?

Appeared in: HPSSSB Staff Nurse - 2016

Explanation

The primary goal after spinal surgery is to maintain the vertebral column in a straight, neutral alignment to prevent injury.
Logrolling is a specific technique where the patient's body is turned as a single, solid unit, with the head, spine, and hips moving simultaneously.
This method prevents twisting, flexion, or extension of the spine, which could disrupt the surgical repair, cause pain, or lead to neurological damage.
Using a draw sheet with the help of other nurses provides the necessary support to execute the logroll safely and effectively.

Option A: Coughing increases intraspinal pressure, which can strain the surgical site and increase the risk of a cerebrospinal fluid (CSF) leak.
Option B: While a pillow is placed between the knees during a logroll, simply instructing the patient to bend their knees to turn is incorrect and dangerous. This action would encourage twisting of the lumbar spine.
Option C: Peritonitis is inflammation of the abdominal lining. A lumbar laminectomy is a surgery performed on the posterior (back) side of the body. This assessment is irrelevant to this procedure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Post-operative nursing care following a lumbar laminectomy as background academic context rather than a clinical decision trigger.
Proper positioning after spinal surgery is a critical patient safety measure to prevent irreversible neurological damage and ensure a successful surgical outcome.
Nurses must educate the patient and their family on the importance of not twisting or bending the back and to always call for assistance for repositioning.
What if? If a patient after a laminectomy needs to sneeze or cough uncontrollably, the nurse should instruct them to splint their back incision with their hands or a pillow. This provides counter-pressure to minimize the sharp increase in intraspinal pressure and support the surgical site.

How to Approach the Question

First, identify the core of the question: It asks for the correct nursing action after a lumbar laminectomy.
Recall the primary principle of post-spinal surgery care: maintaining spinal alignment and preventing injury to the surgical site.
Evaluate each option based on this principle.
Option A (coughing) increases spinal pressure, which is harmful.
Option B (bending knees to turn) promotes spinal twisting, which is harmful.
Option C (assessing for peritonitis) is irrelevant as it relates to abdominal, not spinal, surgery.

Concept Tested & Keywords

Q1nLhe6HFk_4PcmFVeGrE7

E6 Nursing Fundamentals Taylor pp. 335-337, 359-361

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

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