Different kinds of Positions.pptx

Various position are shown in the slides to comfort the patient and various positions used for physical examination

1. POSITIONS Prepared by: Rashmi Goswami F.Y M.Sc Nursing C.M.P.C.O.N

2. The nurse uses a variety of interventions to bring comfort and relief to her patients. Positions used for comfort are one of the important aspects in nursing interventions. Nurses caring for clients in many settings and situations can adapt various comfortable positions, to provide them a comfortable stay. Moreover, different positions are used for physical examinations so that the body parts are accessible and the client's stay is comfortable. INTRODUCTION

3. Positioning defined as placing the person in such a way to perform therapeutic interventions to promote the health of an individual. Positioning defined as placing the person in a proper body alignment for the purpose of preventive, promotive, curative, and rehabilitative aspects of health DEFINITION

4. PURPOSE

5. PRINCIPLES OF POSITIONING

6. COMMON COMFORT POSITIONS

7. Recumbent or Supine and Dorsal Position The patient lies on his back with his head and shoulders are slightly elevated. Indication: Examination of the chest and Abdomen. Purpose: To provide comfort to the patient. To check vitals To perform physical examination During surgical procedures an post operatively.

8. Semi-recumbent position/Low Fowler’s In this position head of the bed is elevated at 30 degree with flexion at the level of waist. Indication: To prevent aspiration during tube feeding. During increased ICP

9. Prone Position In the prone position the patient lies flat in bed with face downwards or sideways with one pillow under the waist and one under the ankles, to take the weight off the toes. Indication: P atients with a Spinal injury, Surgery spine , B ack injuries , B urnt over back etc.

10. Lateral or side lying position: (Right or left) In the side lying position the patient lies on his side with both knees slightly flexed towards the abdomen, one knee more acutely than the other. Pillows can be placed at the head, back and at the sides for support and between the knees. The left lateral position is used for giving enema or suppositories

11. Fowler's Position: Fowler's position is a semi-sitting position with head elevated to 30 with the support of back rest and pillows. U nder the arms and knees extra pillows to be placed .

12. Indication: C hest and abdominal operations to promote drainage. Also in patients with dyspnoea, as this position expands the thoracic cavity by pushing the diaphragm down. To prevent the risk of choking. Nasogastric tube intubation To relieve respiratory disorder such as COPD, Asthma, Emphysema, etc.

13. Cardiac/ O rthopneic position In the cardiac position the patient is in high Fowler's position, a cardiac table is placed in front of the patient with a pillow for him to lean on. It relieves dyspnoea, and adds to the comfort of the patient.

14. POSITIONS USED FOR PHYSICAL EXAMINATION

15. Dorsal or Horizontal recumbent It is a back-lying position with legs extended or knees flexed according to the need. A small pillow is placed under the head. In this position client with painful disorders are more comfortable with knees flexed.

16. Erect Position or Standing: This is the normal standing position with both feet on the floor. In this position the patient is examined for orthopedic and neurological disorders or for hernia .

17. Sim's or Left Lateral Position: In Sim's position the patient lies on his left side with one pillow under the head and the left cheek resting on it . The left arm is drawn behind the back and the right arm in any position comfortable for the patient. The right thigh is flexed against the abdomen. This position is used for rectal and vaginal examination.

18. Knee Chest Position In the knee-chest position the patient rests on the knees and the chest. The head is turned to one side with the cheek on a pillow. A small pillow may be placed under the chest. The arms are placed at the sides of the head. The weight is resting on chest and knees. The knees are flexed in a kneeling position and the thighs are at right angles to the legs . This position is used for rectal, vaginal examination and management of prolapsed uterus

19. Trendelenburg position In the Trendelenburg position the patient lies on his back, the foot of the bed is elevated at 45° angle. The head is low and the body is on inclined plane. This position is used in surgery of pelvic organs. To shift abdominal organs upward during certain surgeries.

20. Lithotomy position Lithotomy position is a back-lying position with feet supported in stirrups . This position is used for rectal, vaginal and urethral examinations, catheterisation and during vaginal deliveries.

21. Maintain good body alignment of the patient at all times. Support body parts in good alignment by using supportive devices to promote comfort and prevent undue muscle strain Avoid prolonged flexion of any one body segment by changing the position at least every two hours Reduce the pressure caused by body weight of his or her body or object by changing the position and using protective devices. GENERAL INSTRUCTIONS

22. Check the patient’s general condition Check the physician’s order for any limited movements Assess the self-care ability of an individual Arrange the comfort devices near the bedside Identify the deformed extremity Support the immobilize area during positioning Identify the rationale before positioning   PRELIMINARY ASSESSSMENT

23. Extra man power if needed Extra pillows Sheets Comfort devices such as back rest, cardiac table, sand bag, etc. EQUIPMENT

24. Explain the procedure to the patient Provide privacy Arrange the articles and manpower (if needed) Untie the bed sheets Turn/lift/ambulate gently Place and support with extra pillows under pressure points Special care taken at pressure areas Cover the patient with top sheet Hand wash Record the time, position and condition of the skin PROCEDURE

25. Positioning a patient in bed is important for maintaining alignment and for preventing bed sores (pressure ulcers), foot drop, and contractures. Proper positioning is also vital for providing comfort for patients who are bedridden or have decreased mobility related to a medical condition or treatment. When positioning a patient in bed, supportive devices such as pillows, rolls, and blankets, along with repositioning, can aid in providing comfort and safety . Cont…

26. Good body alignment can be achieved in any of the bed rest positions. The following points should be checked. - Head should be in midline with the trunk - Back should be straight, with normal body curves (cervical, thoracic, and lumbar) maintained - Ribs should be elevated to prevent constriction of the chest - Arms and legs should be in a position of function (the position for maximum usefulness of the joints, feet and hands) Cont…

27. - Position of function of leg and feet. This position favors standing upright and walking. In general, if the toes point to the ceiling when in a back-lying position and point to the floor when in a front-lying position, the feet, legs, and hips are in good alignment. - Position of function of arms and hands. This position favors raising arms and grasping things with the fingers. The hand should not droop at the wrist, be clenched in a fist, or be flat. The position of function for the hand is dorsiflexion (at a slight upward angle) at the wrist, with the fingers and thumb in position to write with a pencil. Cont…

28. Positions used for comfort and physical examinations are one of the very important interventions by nurses. Patients’ ability to assume positions depends upon their physical strength and degree of wellness. Their privacy should be kept as the top priority while doing physical examination as it will keep them at ease and provide greater accessibility and accuracy in assessing body parts. SUMMARY

29. Assignment