Please help with NCLEX Question

ChristineN, BSN, RN · Jul 7, 2008

Hi everyone,
I have a question regarding position after surgical repair of detached retina, in NCLEX 3500 says to place the patient lie on his back or on the unaffected side to reduce pressure on the other hand in Kaplan says to place the patient on the affected side. Please any clarification about this, I will appreciate it.

I thought you always placed a pt on the unaffected side after any sort of eye surgery?

jadu1106 · Jul 7, 2008

i thought you always placed a pt on the unaffected side after any sort of eye surgery?

i agree with you christinen.....

fotero,

here is a post on the random facts thread...

https://allnurses.com/forums/f197/anyoone-up-random-fact-throwing-308584-25.html

post #250 by rootedredwood.....has positioning techniques listed...and detached retina is one of them....check it out!

hope it helps!

good luck!

jadu1106 · Jul 7, 2008

fotero,

kaplan's 9th edition blue book, page pg 363 for detached retina....

hope this is helpful!!

RNFutureRN · Jul 7, 2008

I agree, the patient must keep pressure off the affected side. If the procedure involved administering a gas to form a seal of the retina the patient must be positioned prone and turn the head so the unaffected eye is down (saunders 906 3rd ed).

CT Pixie, BSN, RN · Jul 7, 2008

Agree w/everyone else. Don't place pt on affected side.

fotero · Jul 7, 2008

thanks everyone for your explanations

eager1hasbegun · Jul 7, 2008

thanks everyone for your explanations

Good lookin out! Don't be afraid to question what books say. While I was in school, my peers and I found many an error in our textbooks that our teachers later confirmed...

mat25:40 · Jul 8, 2008

I checked in HOGAN, a nursing textbook.

It depends on area of datachment. Position patient with detached area dependent/inferior so gravity pushes detachment closer to choroid (e.g., with left eye superior temporal detachment, keep client supine with head turned toward left). Hope this helps.

teebee · Jul 8, 2008

I checked in HOGAN, a nursing textbook.
It depends on area of datachment. Position patient with detached area dependent/inferior so gravity pushes detachment closer to choroid (e.g., with left eye superior temporal detachment, keep client supine with head turned toward left). Hope this helps.

right, we were taught that a detached retina is the exception to the general rule of positioning the unaffected side inferior/dependent. The pressure is necessary to reestablish contact between retina and choroid in order to prevent ischemia --> possible permanent loss of vision.

fotero · Jul 8, 2008

Agree with Tabee, that is why I was confused. Just for clarification.

In any eye surgery EXCEPT retina detachment position the patient on the UNAFFECTED side, correct?

jsu102 · Jul 8, 2008

Yep, I was also taught that detached retina is the exception to the rule in positioning after eye surgery.

Other surgeries (i.e. cataract) place on unaffected side.

Detached retina place on affected side since gravity can help shift things into place.

I actually just had this question on my Kaplan QBank 2 days ago and the rationale definitely said place patient on AFFECTED side.