The client with right-sided pleural effusion by chest x-ray is being prepared for a thoracentesis. The nurse assists the client to which of the following positions for the procedure?
1. Sims position, with the head of the bed flat
2. Left side-lying position, with the head of the bed elevated 45 degrees
3. Prone, with the head turned to the side supported by a pillow
4. Right side-lying position, with the head of the bed elevated 45 degrees
2
Rationale: To facilitate removal of fluid from the chest wall, two positions may be used. The client may be positioned sitting on the edge of the bed, leaning over the bedside table, with his or her feet supported on a stool. The other position is lying in bed on the unaffected side, with the head of the bed elevated 45 degrees (Fowler's position). The other options are incorrect because they do not facilitate drainage of fluid to an area easily removed with thoracentesis.
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