A male client has undergone spinal surgery, the nurse should:
A. Observe the client’s bowel movement and voiding patterns
B. Log-roll the client to prone position
C. Assess the client’s feet for sensation and circulation
D. Encourage client to drink plenty of fluids
Correct Answer: C. Assess the client’s feet for sensation and circulation
Alteration in sensation and circulation indicates damage to the spinal cord, if these occur, notify the physician immediately. Assess movement and sensation of lower extremities and feet (lumbar) and hands or arms (cervical). Although some degree of sensory impairment is usually present, deterioration and changes may reflect development or resolution of spinal cord edema and inflammation of the tissues secondary to damage to motor nerve roots from surgical manipulation.
Option A: After surgery, the bowel and bladder patterns of the client would not immediately return to normal. The anesthesia would take time to wear off. Catheterize for bladder residual after voiding, when indicated. Insert and maintain indwelling catheter as needed. Intermittent or continuous catheterization may be necessary for several days postoperatively until the swelling is decreased.
Option B: Keeping the spine aligned correctly is important after surgery in order to minimize its workload and reduce the risk of disrupting the healing process. Only physical and occupational therapists would be allowed to work with the patient regarding his activity. Logroll patient from side to side. Have the patient fold arms across the chest, tighten long back muscles, keeping shoulders and pelvis straight. Use pillows between knees during position change and when on the side. Use a turning sheet and sufficient personnel when turning, especially on the first postoperative day.
Option D: Drinking immediately after surgery would not be allowed since the gag reflex has not yet returned to normal. Choking would be a great risk. After the test, urge the patient to remain in bed with his head elevated, especially if metrizamide was used. To relieve the patient from discomfort and frustration of low back pain.