Which position is most appropriate after tonsillectomy of child?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

The side-lying position is the safest for a child immediately after a tonsillectomy.
This position uses gravity to facilitate the drainage of blood and oral secretions out of the mouth.
It is the most effective method to prevent aspiration while the child is recovering from anesthesia and their gag reflex is suppressed.
Maintaining a patent airway is the highest priority in the immediate postoperative period.

Option A: The supine (on the back) position allows blood and secretions to pool in the pharynx, creating a high risk of aspiration into the lungs.
Option B: The Trendelenburg position (head down) increases venous pressure in the head and neck, which can increase the risk of hemorrhage from the surgical site.
Option D: A high Fowler's (sitting upright) position is not appropriate until the child is fully awake, alert, and able to control their own secretions. In the immediate postoperative phase, the risk of aspiration is too high.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Postoperative positioning following tonsillectomy in a pediatric patient as background academic context rather than a clinical decision trigger.
Airway management is the top priority for a post-tonsillectomy patient. Correct positioning is a critical nursing intervention to prevent life-threatening aspiration.
A key sign of postoperative bleeding is frequent swallowing. Nurses must monitor for this subtle sign and report it to the surgeon immediately, as it may indicate a hemorrhage.
Patient and parent education is vital. Instructions should include avoiding straws, discouraging coughing or throat clearing, and offering a soft, cool diet.

How to Approach the Question

First, identify the core issue of the question: patient safety immediately after a tonsillectomy.
Recall the primary risks in the immediate postoperative period for this specific surgery: bleeding and aspiration.
Analyze each position based on how it affects these risks. The goal is to choose a position that protects the airway.
Evaluate the supine position: it increases aspiration risk. Eliminate it.
Evaluate the Trendelenburg position: it increases bleeding risk. Eliminate it.
Evaluate the high Fowler's position: it is unsafe until the patient is fully awake. Eliminate it for the immediate post-op phase.

Concept Tested & Keywords

Concept Tested: Postoperative positioning following tonsillectomy in a pediatric patient.
Stem keywords: position, after tonsillectomy, child
Lead-in keywords: most appropriate
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

QO9YmEHa8fuys3F5ofuTXW

E6 Nursing Fundamentals Potter Perry 12e Part 4 pp. 155-157, 202-204

Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Attempt every question from this paper in a timed mock, then review the full solution for each one.