Tonny has undergone a left thoracotomy and a partial pneumonectomy. Chest tubes are inserted, and one-bottle water-seal drainage is instituted in the operating room. In the postanesthesia care unit, Tonny is placed in Fowler’s position on either his right side or on his back. The nurse is aware that this position:
A. Reduce incisional pain.
B. Facilitate ventilation of the left lung.
C. Equalize pressure in the pleural space.
D. Increase venous return.
Correct Answer: B. Facilitate ventilation of the left lung.
Since only a partial pneumonectomy is done, there is a need to promote expansion of this remaining left lung by positioning the client on the opposite unoperated side.
Option A: This position may reduce the pressure on the surgical incision site, but it is not its priority.
Option C: Fowler’s position is associated with improvement of functional residual capacity, oxygenation, and reduction of work of breathing.
Option D: On the transition from sitting to standing, blood is pooled in the lower extremities as a result of gravitational forces. Venous return is reduced, which leads to a decrease in cardiac stroke volume, a decline in arterial blood pressure, and an immediate decrease in blood flow to the brain.