During the physical examination of a client, the nurse checks the client for neck vein distention. To perform this assessment properly, the client should be positioned
A) first lying, then sitting, then standing.
B) in a side-lying position with knees flexed.
C) lying supine with head of bed elevated 15-30 degrees.
D) sitting upright with neck flexed slightly forward.

Question

Quizplus · Accepted Answer

The distensibility of the neck veins reflects the pressure and volume changes within the right atrium in most people. Evaluate neck vein distention by having the client lay supine with the head of bed elevated 15-30 degrees (for most people), turn the client's head slightly away from you, loosen or remove clothing that compresses the neck or upper thorax. Use oblique lighting and observe both sides of the neck. Measure the highest point of venous pulsation.

During the Physical Examination of a Client, the Nurse Checks