# The picture below shows a surgical position. Which type of surgery requires this position?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=491179  
> language: ko  
> subject: Nursing

## 문제

The picture below shows a surgical position. Which type of surgery requires this position?

![5becd75ec6e58218691106c4bc0c8fe4_1712133095_9404.png](https://mymerci.kr/data/editor/2404/5becd75ec6e58218691106c4bc0c8fe4_1712133095_9404.png)

## 보기

1. Lung surgery **✔ 정답**
2. Cardiac surgery
3. Abdominal surgery
4. Rectal surgery
5. Spinal surgery

**정답: 1**

## 해설

This is the lateral position, in which the client lies on one side; it is used for kidney or lung surgery.

## 심화 해설

Key Nursing Concept
This item asks about the indications for the lateral position among surgical positions. The position shown in the picture is one in which the client lies on the side, and it is used mainly for surgeries requiring access to the thorax or the flank (lateral aspect).

**Rationale for the correct answer (lung surgery):** The lungs are located on the right and left sides within the thoracic cavity. For lung procedures such as a lobectomy or wedge resection, the client is placed in the lateral position with the operative side up, depending on the surgical site. This provides the surgeon with optimal access to the lung through the lateral chest wall.

**Why the other options are incorrect:**

- **Cardiac surgery:** Most cardiac procedures are performed through a median sternotomy, so the client is placed in the Commonly confused! supine position.

- **Abdominal surgery:** Most abdominal procedures (stomach, bowel, liver, gallbladder, etc.) are approached through the anterior abdomen, so the supine position is used.

- **Rectal surgery:** For rectal and anal procedures, the lithotomy position or the prone position is more common.

- **Spinal surgery:** Posterior spinal approaches use the prone position, while anterior approaches generally use the supine position.

High-Yield Exam Point
Surgical positioning is critical for both surgical access and client safety. Memorize the major positions paired with their indications.

| Surgical position | Common indications | Features/precautions |
| --- | --- | --- |
| Supine | Abdominal, cardiac, thyroid, breast, extremity surgery | The most commonly used position |
| Lateral | Lung and kidney surgery | Watch for nerve/vessel compression of the dependent arm and leg |
| Prone | Posterior spine, occipital, and buttock surgery | Respiration, facial pressure, and eye protection are essential |
| Lithotomy | Rectal, anal, gynecologic, and urologic surgery | Watch for impaired lower-extremity circulation and nerve injury |
| Trendelenburg | Lower abdominal and pelvic surgery | May limit respiratory function and cause headache |

## 임상 시나리오

Clinical Nursing Practice Guide
When caring for a client undergoing lung surgery in the lateral position, preventing position-related complications is the top priority.

**Priority nursing interventions:**
1.  **Protect pressure points:** Provide adequate padding so that the axillary nerve of the dependent arm and the peroneal nerve of the leg are not compressed. In particular, support the dependent arm on an armboard and place a pillow between the knees to protect the dependent leg.
2.  **Maintain respiration and circulation:** Make sure the upper chest does not press down on the dependent side, and make small positional adjustments as often as possible (limited during surgery) to promote circulation.
3.  **Secure the client safely:** Use straps at the hips and shoulders to keep the client from shifting during surgery, while avoiding excessive pressure.

**A word from an experienced nurse:** "The lateral position is convenient for the surgical team, but it is an unnatural position for the client. Think of it as being frozen in place after rolling onto your side in your sleep. That's why, after surgery, you must carefully assess sensation, movement, and circulation in the areas that were under pressure. Numbness or weakness in the dependent arm, in particular, should raise suspicion of axillary nerve injury."

## 핵심 개념

- **Lateral position** — A surgical position in which the client lies on one side. It is used mainly for lung, kidney, and some thoracic or flank procedures, and preventing neurovascular compression of the dependent extremities is essential.
- **Supine position** — The most basic surgical position, in which the client lies flat on the back. It is used for a wide range of procedures, including abdominal, cardiac, thyroid, and extremity surgery.
- **Prone position** — A position in which the client lies face down. It is used mainly for posterior spine, occipital, and buttock surgery. Protecting respiration and the face/eyes from pressure is essential.
- **Lithotomy position** — A position in which the client lies on the back with both legs raised and secured in supports. It is commonly used for rectal, anal, gynecologic, and urologic surgery.
- **Axillary nerve** — An important nerve that supplies motor and sensory function to the shoulder joint and deltoid muscle. In the lateral position, compression of the axilla of the dependent arm places this nerve at risk for injury.

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