positioning of patient

Patients position

1. POSITIONS
A.Deeparani.,RNRM
D.N.S
Prashanth Hospitals,Velacherry,Chennai-42

2. DEFINITION
Positioningisdefinedasplanningthepersonina
properbodyalignmentfor
preventive,promotive,curative
thepurposeof
andrehabilitative
aspects of health or placing the patient in good body
alignment as neededtherapeutically.

3. PURPOSES
To promote comfort to thepatient
To relieve pressure on variousparts
To stimulatecirculation
To provide proper bodyalignment
To carry out nursingintervention
To perform surgical and medicalinterventions
To prevent complications caused by immobility
To promote normal physiologicalfunctions

4. PRINCIPLES
1.Maintain good bodymechanics
2.Wash hands before and afterprocedure
3.Ensure patient’scomfort
4.Obtain assistance asrequired
5.Ensure that mattress is firm and level of bed is at
workinghide
6.Follow safety measures to preventaccidents
7.Follow the systematic and orderly way ofdoing
8.Use right technique at righttime

5. 1. SUPINEPOSITION
Thepatientliesonhisbackwithhisheadand
shoulders are slightlyelevated
Indication
Usualposition
Examination of the chest andabdomen

7. PROCEDURE
Placethepatientonbackwithonepillowunderthe
head,armsandhandsatthesides,kneesflexed
andseparated.
Placetheairringunderthehipsandcottonorfoam
padsundertheheelstoreducethepressure.
Place footboard under bottom offeet.
Ifthepatientisaparalyzed,placehandroleinhand.
Align the patient’s body in goodposition.

8. AIRBAGS FOOTBOARD

9. 2. PRONEPOSITION
Positioninwhichthepatientliesontheabdomen
withtheheadturnedtoonesidewithonesmall
pillowundertheankle.
Indications
Postoperatively
burns,injuriesandPatientwithpressuresores,
operations on theback.
To relieve abdomendistension

11. CONTD..
Indications..
Renalbiopsy.
Examine theback
For patients after 24 hours of amputation of lower
limbs

12. PROCEDURE
Explain theprocedure
Provideprivacy
Place the patient flat on abdomen with one pillow
under thehead
Turn patients head to one side and align the patient
in goodposition
Place both arms at the side of the head and support
arm in flexed position at level ofshoulder.
Support lower legs with pillows toelevate toes.

13. 3. LATERALPOSITION
Theclientliesonthesidewithweightonhipand
shoulderorthepatientliesonhissidewithboth
armsforwardandhiskneesandhipsflexed.
The upper leg is flexed more than the lowerleg.
Theupperkneeandhipshouldbeatthesame
level.
Apillowisgivenunderthehead,backandfrontto
supportthearmsandabdomen.
Asmall pillow is given in between the knees.

15. INDICATIONS
Patients who requires periodic position
changes
In immediate post-operativepatients
Used for examination ofperineum
Insertingsuppositories.
For taking rectaltemperature.
Giving backcare
For giving enema and colonicirrigation.

16. PROCEDURE
Explain theprocedure
Provideprivacy
Lower the head of bed as low as patient cantolerate.
Position the patient to side ofbed
Turn the patient toone side

17. CONTD..
Place the air ring under the hips to reduce pressure in
trochanters and at the hipjoints.
Position both arms in flexed position. Upper most arms
are supported by pillow on level withshoulder.
Place pillow underback
Place pillow under semi flexed upper leg at hip, from
groin tofoot.
Place sand bag parallel to plantar surfaceof
dependentfoot.

18. 4. LITHOTOMYPOSITION
The client lies supine with hips flexed. The legs are
separated and thighs areflexed.
The patient’s buttocks are kept at the edge of the
table and legs are supported bystirrups.

20. INDICATIONS
For delivery ofbaby
For rectal examination &surgeries
For vaginal examination &hysterectomy

21. PROCEDURE
Explain the procedure to thepatient
Provideprivacy
Position the patient to lie on his back withone pillow
under thehead
Keepthelegswellseparatedandthethighswell
flexed on the abdomen and the legs on thethighs
Buttocks are kept on the edge of the table and the
legs are supported onstirrups

22. 5. DORSAL RECUMBENT POSITION
Patientliesonback,kneesfullyflexed,thighs
flexedandexternallyrotatedfeetflatonthebed.
Inthispositionclientswithpainfuldisordersare
morecomfortablewithkneesflexed.
Thispositionshouldnotbeusedforabdominal
assessmentbecauseitpromotescontractionof
abdomenmuscles.

24. INDICATIONS
douche,Itisusedforcatheterization,
vaginal vulval, vaginal and rectal
examination
It is also used for vaginal operations and insertion
oftampons

25. PROCEDURE
Place the patient on back in bed with two or more
pillows under the head for patient’scomfort.
Place the air ring under the hips and cotton rings or
foam pads under the heels to reducepressure.

26. 6. FOWLER’SPOSITION
Itisasittingpositioninwhichtheheadiselevated
at45˚to60˚,andtheclientkneesareslightly
elevated,avoidingpressureonthepopliteal
vessels.
Backrestandtwopillowsareusedforthebackand
head.Pillowscanbeusedtomaintainnatural
alignmentofthehandswristandforearms.

31. INDICATIONS
To relievedyspnea
To improvecirculation
Torelaxthemusclesoftheabdomen,back
and thighs.
To relieve tension on abdominalstature.

32. PROCEDURE
Explain theprocedure
Elevate the head of thebed
Rest the head against mattress or smallpillow.
Use pillow to supportarm.
Place a small pillow at lowerback.
Placefootboardatbottomofpatient’sfeet.
Place the patient in sitting position with arms atsites
a nd knees raised withpillow.

33. 7. SIMSPOSITION
Inthispositiontheclientliesoneithertherightor
leftside.
Thelowerarmbehindthebodyandupperarmis
bentattheshoulderandelbow.
Thekneesarebothbent,withtheuppermostleg
moreacutelybent.
Thesepositionssimilartothelateralpositionexcept
thatthepatient’sweightisontheanterioraspectof
thepatient’sshouldergirdleandhip.

35. INDICATIONS
Vaginal and rectalexamination
Administration of enema andsuppository
Used for relaxation in antenatalexercises
Position for sigmoidoscopy andprotoscopy

36. SIGMOIDOSCOPY
PROTOSCOPY

37. PROCEDURE
Explain the procedure to thepatient
Provideprivacy
Place the patient on theside
Place small pillow under head andneck
Placepillowunderflexedupperarm,supportingarm
level withshoulder.
Place pillow under flexed upper leg, supporting leg level
withhip.
Place sand bags parallel to plantar surface of dependent
foot.

38. 8. TREDLENBERGPOSITION
Inthisthepatientliesonthebackwiththehead
low.
Thefootofthebediselevatedat45˚angle.Entire
frameofbedistiltedwithheadofbeddown.

40. INDICATION
Usedinemergencysituationslikeshock,
hemorrhage and hypotension
Posturaldrainage
Patients with deep vein
thrombosis

41. PROCEDURE
Explain the procedure topatient
Place the patient in supineposition
Lowertheheadendofthebedorifitisnot
adjustabletype,usebedblockatfootendandtilt
entireframeofbeddown.ORelevatethefoot
endat45˚angle.
Thepatientiscarefullysupportedtoprevent
fromslipping.

42. 9. KNEE CHESTPOSITION
The patient rests on the knees and thechest.
Thebodyisat90˚angletothehipswithback
straight,thearmabovethehead,andthehead
turnedtooneside.
The abdomen remainsunsupported.

44. USES
Used for vaginal and rectalexamination
Usedinfirstaidtreatmentincordprolapseor
retroverteduterus
Asexerciseforpostpartumandgynecology
patients.

45. PROCEDURE
Explain the procedure to thepatient
Make the patient rest on the knees andchest
The head is turned to one side with the cheek on a
pillow.
Thearmshouldbeextendedonthebedandflexed
attheelbowstosupportthepatientpartially.

46. 10. ORTHOPNEICPOSITION
•Highfowler’spositionwithoverbedtabletobe
placedacrossthefrontofthepatient.
•Patienttorestbothhandsonoverbedtable/on
pillowplacedinitandleansforward.
•Leaningforwardfacilitatesrespirationbyallowing
maximumchestexpansionbyreducingpressure
ofabdominalorgansondiaphragm.

48. INDICATIONS
•Patients with severedyspnea
•Cardiacpatients
•Position forthoracocentesis
•Patientwith chest drainagetubes