The nurse prepares a client with the diagnosis of right pleural effusion for a thoracentesis; however, the client experiences severe dizziness when sitting upright. Which alternate position should the nurse assist the client into to maintain safety during the procedure?

1. Right side-lying with the head of the bed flat
2. Prone with the head turned toward the affected side
3. Sims’ position with the head of the bed elevated 45 degrees
4. Left side-lying with the head of the bed elevated 45 degrees

Correct Answer: 4

A thoracentesis is a procedure in which fluid or air is removed from the pleural space via a transthoracic aspiration. Positioning can help isolate the fluid in a pleural effusion; generally, the client sits at the edge of the bed, leaning over the bedside table, allowing the fluid to collect in a dependent body area. If the client is unable to sit up, the nurse turns the client to the unaffected side and elevates the head of the bed 30 to 45 degrees. Turning to the affected side, the prone, and the Sims’ positions are unsuitable positions for this procedure because these do not facilitate fluid removal.