changing postion.pptx

7/28/2019 changing postion.pptx

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CHANGING POSITION OF

HELPLESS PATIENT

Sushmita Kaldan

B.Sc Nursing 4th yr

2009 BatchBPKIHS


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CONTENTS

1. Introduction

2. Definition of position

3. Different types of positions4. Reasons for changing the position of a patient

5. Basic principles in positioning of patient

6. Protective positioning7. Nurses responsibility while changing the position of

patient

8. Procedure for turning a client in bed4/22/2013 2


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1.INTRODUCTION

One of the basic procedures that nurses perform most frequently is

that of changing the patients position.

Any position , even the most comfortable one, will become

unbearable after a period of time.


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Whereas the healthy person has the ability to move at will , a sick

persons movements may be limited by disease , injury or

helplessness.

It is often the responsibility of the practical nurse to position the

patient and change his position frequently.


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DEFINITION

The manner in which body is arranged iscalled position.


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DIFFERENT TYPES OF

POSITIONS FOR PATIENTS


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TYPES OF POSITION

1. SUPINE POSITION:

This is the most common position used during

examination of chest and abdomen.

The patient lies on the back with one pillow

under the head. Arm lies on side, knees are

slightly flexed. The head is turned to one side.

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2. PRONE POSITION

The patient lies flat on bed with face downwards and

backwards and hands folded over pillow. One pillow

is given under head for resting of chin and hands,another is given below abdomen and one under legs.

This position is useful in postoperative cases,

tonsillectomy, fistula operation, operation over spine,

injury over back, to prevent bedsore, to relieve

abdominal distension and for good postural drainage.

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3. LITHOTOMY POSITION

This is usually used for gynecological purpose for

adequate exposure of pelvis and vagina.

Like dorsal position the patient lies flat facing

upwards. But the legs are held or fixed in position by

lifting from table and hanged by steps or attachments

especially fixed on the table.

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LITHOTOMY POSITION

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4. DORSAL RECUMBENT POSITION

The patient lies on her

back, knees fully flexed,

thighs flexed andexternally rotated. Feet

flat on the bed.

It is used forcatheterization, vulval,

vaginal and rectal

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5. SIMS POSITION

This is also known as prone position. This is used for examination of

rectum or vagina.

The patient lies on left lateral position slightly prone with buttocks drawn

slightly backwards to the edge of the bed. The right arm remains in front of

the patient, the right knee is flexed against the abdomen. The left leg lies

straight on the bed. For better comfort a small pillow may be given under

abdomen.

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SIMS POSITION

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6. LATERAL POSITION

This can be left or right

lateral position.

This is used for giving

back care, enemas,

colonic irrigation, for

gynecologicalexamination and for

rectal examination.

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LATERAL POSITION

Patient lies in left or rightlateral position with legsflexed at thigh and knees.

Buttocks are brought tothe edge of the bed.

The upper leg is flexed

more than the lower leg. Itis better to put one pillowfor resting of upper leg

behind the lower leg.

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7. KNEE CHEST POSITION

This is absolutely

used for

gynecological

purpose like

examination of vagina

and rectum and for

first aid treatment forcord prolapse and

retroverted uterus.

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KNEE CHEST POSITION

The patient lies with chestdownwards facing down on the

bed. Knees and thighs are flexed

with buttocks high up in air.

The thighs remain at right angleto bed and knees take weight of

hip or lower position ofabdomen. The head remains onthe side with one side of cheekon pillow.

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The hands are flexed at elbow and rests on either side

to give support to keep body in stable position. A small

pillow can be given under chest. Abdomen remains

above bed in air.

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8. TRENDELENBURG POSITION

This position is used while

doing operation over pelvic

organs to displace intestine

into upper abdomen.

Used for patient of shock.

Also used to check bleeding

from lower limbs.

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TRENDELENBURG POSITION

In this position the patient lies

on back with head lowered andbody on inclined plane with

hips higher than the bed.

Good padding is given over

shoulder to keep the patient

from sliding towards lower end

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9. FOWLERS POSITION

The semi sitting position or

fowlers position, calls for the bed

to be elevated45- 60 degrees.

This position is often used to

promote cardiac and respiratory

functioning because abdominalorgans drop in this position,

thereby providing maximal space

in the thoracic cavity.

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FOWLERS POSITION

This is also a position of

choice for eating,

conversation, vision and

during urinary and bowel

elimination.

High Fowler- 90 degree Semi Fowler- 45-60 degree

Low Fowler- 30 degree

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10. SITTING POSITION

Patients should be positioned

in a comfortable, well-

constructed chair, so that the

head and the spine are erect.

The back and buttocks should

be up against the chair back.The feet should be flat on the

floor.

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SITTING POSITION

1. Pillows or postural supports

may be needed to maintain theposition.

2. A small pillow may be folded

and placed at the small of theback to add comfort and

support.

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REASONS FOR CHANGING THE POSITION OF A

PATIENT

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REASONS FOR CHANGING THE POSITION OF A

PATIENT

To promote comfort and relaxation.

To restore body function.

To prevent deformities.

To prevent bed sore.


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To stimulate circulation.

To facilitate range of motion exercises.

To carry out any nursing procedure

efficiently and effectively.

To maintain correct body alignment and to

facilitate physiological and physical

wellbeing.


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BASIC PRINCIPLES IN POSITIONING OF PATIENTS

Maintain good patient body alignment.

Maintain the patients safety.

Reassure the patient to promote comfort and cooperation.

Elevate the height of the bed as necessary so that it becomes less

strenuous to work for the nurse herself.


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Properly handle the patients body to prevent painor injury.

Keep in mind proper body mechanics as a nurse.

Be aware of the patients limitations and

restrictions.

Obtain assistance to move heavy or helplesspatients.

Follow physicians orders.


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PROTECTIVE POSITIONING

Correct positioning technique

The need to change positionfrequently, at least every 2 hours.

Exercising the extremities andmassaging the pressure areas.

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NURSES RESPONSIBILITY

1. Help the patient assume the desired or required bed position. The nurse

assists the patient to achieve proper body positioning and alignment.

2. Support patients body in correct alignment using pillows or splints.

3. Assure the proper use of supportive devices.4. Frequently monitor and evaluate the position selected.

5. Provide skin care.

6. Ensure proper body mechanics.

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HOW TO TURN A CLIENT IN

BED? The procedure is:

1. Explain the procedure to the patient.

2. Wash hands3. Raise the bed to your waist level. Adjust to flat

position or as low as the client can tolerate. Lower

side rail nearest to you and raise the opposite side.

4. Position the client closer to the far side of the bed in

the supine position.

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CONT

5. Place the clients arm across the chest, cross the

clients far leg over the near one.

6. Stand opposite the clients centre with your feet

spread and one foot ahead of the other. Tighten your

gluteal and flex your knees.

7. Position your hand on the clients far shoulder and

hip and roll the client towards you.

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CONT

8. Make the client comfortable and positioning proper

alignment.

9. Readjust the bed height and position and raise side

rail if appropriate.

10. Wash your hands.

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LETS REVISE

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SUMMARY

SAQs:

1. What are the various purposes of positioning?

2. Enlist various types of positions.

MCQs:

1. The common position required for back care is:a. Supine position b. prone position

c. Lateral position d. fowlers position

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cont

2. The head of bed is elevated to. degree in high fowlers

position.

a. 30 degree b. 45 degree

c. 60 degree d. 90 degree

3. Appropriate position for the patient having difficulty in

breathing is:a. Supine position b. Fowler position

c. Lithotomy position d. Lateral position

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REFERENCES

1. Textbook of adult nursing. Health learning materials centre.2008.Page

no:336-339

2. Gupta LC, Practical nursing procedure, 3rd edition, page no: 184-191

3. Mehta RS, Mandal GN,NursingConcept, Makalu publication house, 2

nd

editioj. Page no: 206-211

4. Taylor Carol, Lillis Carol, Fundamental of nursing, 6th edition, page no:

1214-1221

5. www.google.com (positioning of patient)

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http://www.google.com%28positioning/http://www.google.com%28positioning/


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changing postion.pptx

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