What should be the position of a pediatric client with pneumonia?

[ygmr6666]

Hi everyone! I am studying for NCLEX-RN. I am so confused about below question because the answer of this question in the book does not match with what I learnt before.

Please help me! Thank you.

Here is the question;

What is the best position for a nurse to place a 3 year old child with right lower lobe pneumonia?

1. on the right side

2. on the left side

3. supine

4. prone

[morte, LPN, LVN]

give your answer and rationale.

[NeoPediRN]

You want to position a child on the opposite side from the affected lung, because if you lay them down on that side you are causing further collapse and less air can move through. Laying a child with the affected side up makes it easier for air to move through.

[ygmr6666]

I believe that the person with pneumonia should be placed on the affected side to prevent discomfort. This position can splint the area but the answer says the patient should be placed on the opposite side.Thank you.

[ygmr6666]

Thanks for your answer. I am confused because Saunders 5. Edition book says the child with pneumonia should be placed on the affected side to splint the chest.

[NeoPediRN]

No, never. You do not splint pneumonia, there is already compromised oxygenation through the lung. A child laying on their affected side may have difficulty keeping their O2 sats up.

[NotReady4PrimeTime, RN]

Here's a journal article supporting the practice of positioning with the "good" lung down: http://www.ferronfred.eu/files/Physiological-Rationale-and-Current-Evidence-for-Therapeutic-Positioning-of-Critically-Ill-Patients.pdf

[ygmr6666]

Thanks a lot for all of you .