IGNOU PB Bsc Nsg Entrance-2017
Nursing Foundation
Medium
The position to be given to an unconscious patient for mouth care is?
Appeared in: IGNOU PB Bsc Nsg Entrance-2017
Explanation
- The side-lying (lateral) position is correct because it uses gravity to promote the drainage of secretions and fluids out of the mouth.
- This position is essential for preventing aspiration (inhalation of fluids into the lungs), which is a major risk in unconscious patients due to a diminished or absent gag reflex.
- By positioning the patient on their side, the tongue is less likely to fall back and obstruct the airway, thus maintaining airway patency during the procedure.
Why Other Options Were Wrong
- Option A: Fowler's position (sitting up) is unsafe for an unconscious patient during mouth care as their head control is absent, which can lead to airway obstruction or aspiration if the head slumps forward or backward.
- Option C: The supine position (lying flat on the back) is extremely dangerous for this procedure. It allows fluids to pool in the pharynx, creating a very high risk of aspiration into the lungs.
- Option D: Trendelenburg position (head down, feet up) is contraindicated. It increases intracranial pressure and promotes the flow of gastric contents towards the mouth, increasing aspiration risk.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Patient positioning and safety during nursing procedures to guide bedside assessment, documentation, and the next nursing action.
- Preventing Aspiration Pneumonia: The primary clinical relevance is the prevention of aspiration pneumonia, a serious and potentially fatal complication in immobile or unconscious patients. Correct positioning is a fundamental nursing skill to ensure patient safety.
- Oral Hygiene and Systemic Health: Regular, safe oral care in unconscious patients prevents not only local issues like parotitis (inflammation of salivary glands) but also reduces the risk of ventilator-associated pneumonia (VAP) in intubated patients.
- What if the patient has a cervical spine injury? If a cervical spine injury is suspected or confirmed, the patient cannot be turned freely. In this case, the log-roll method with another staff member maintaining cervical alignment would be used to move the patient to a side-lying position, or if not possible, suction must be used continuously during care in a neutral position with the head of the bed elevated.
How to Approach the Question
- First, identify the key elements in the question: 'unconscious patient' and 'mouth care'.
- Recognize that an unconscious patient lacks protective reflexes, such as the gag reflex.
- The primary risk associated with giving fluids or care in the mouth of an unconscious patient is aspiration.
- Evaluate each position based on how it affects the flow of fluid due to gravity.
- Supine and Trendelenburg positions would cause fluid to flow towards the lungs.
- Fowler's position is risky due to lack of head control.
Concept Tested & Keywords
- Concept Tested: Patient positioning and safety during nursing procedures.
- Stem keywords: unconscious patient, mouth care, position
- Lead-in keywords: The position to be given
- Clinical cues: Patient status: Unconscious - this is the critical detail indicating impaired protective reflexes like gagging and swallowing.
Question ID
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Reference Book
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 26-28
E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 155-157
Practise the full IGNOU PB Bsc Nsg Entrance-2017
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