positioning clients
Terms
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- Fowlers position
- semi-sitting position in bed with head and trunk raised 45-90 degrees ( for difficulty breathing, cardiac problems.
- Common problem made with fowlers position
- placing too large a pillow behind clients head, can promote neck flexion contractures due to poor neck alignment.
- semi-fowlers position
- head and trunk raised 15-45 degrees
- high fowlers position
- head and trunk raised 90 degrees (knees may be flexed to prevent friction and shear injuries to skin)
- orthopneic position
- sits in bed or on the side of the bed, leaning on over-bed table- facilitates respiration by allowing maximum chest expansion, particularly helpful to clients having problems exhaling or COPD.
- dorsal recumbent (back lying)
- client's head and shoulders slightly elevated on a small pillow-provides comfort -facilitates healing following certain surgeries or anesthetics (spinal)
- supine
- back lying without pilow
- prone
- client lies on abdomen w/ head turned to one side- allows full extension of hip and knee joints-helps prevent flexion contractures of hips and knees-promotes drainage from mouth for unconsciuos cients or following mouth or throat surgeries
- disadvantages of prone pos.
- prolonged pull of gravity produces marked lordosis, neck is laterally rotated, causes plantar flexion, can be suffocating to clients w/ cardiac or resp. problems, not recommended w/ cervical or lumbar spine problems
- lateral
- client lies on one side of body or the other-flexion reduces lordosis and promotes good back alignment-relieves pressure on sacrum and heels-body wt is borne on lateral aspect of lower scapula or ilium or greater trochanter of the femur-good for resting and sleeping
- sims (semi-prone)
- position halfway b/n lateral and prone positions-lower arm positioned behind client, upper arm flexed at shoulder and elbow-both legs flexed in front of client with upper leg more acutely flexed-facilitates drainage from mouth and prevents aspiration-reduces pressure over sacrum and greater trochanter of paralyzed clients- used for giving enemas or exams/treatment of perineal area- comfortable sleeping pos for pregnant women.
- trendelenburg
- body resting flat on an inclined plane w/ head lower than legs-sometimes used in pelvic surgery-pvd procedure-contraindicated in shock-client w/ shock or hypotension should be placed flat w/ small pillow under head, legs elevated at a 45 degree angle
- reverse trendelenburg
- body resting flat on an inclined plane w/ legs lower than head-prevents reflux- decreases intercranial pressure assoc. w/ head injury- raising just head of bed can increase ICP by constricting blood flow to lower extremities
- lithotomy (dorso-sacral)
- client lying supine w/ the hips and knees flexed and the thighs abducted and rotated externally-child birth-some surgeries
- knee-chest(genupectoral)
- body weight is supported on knees and chest w/ buttocks raised, head is turned to one side, and arms are flexed so upper part of the body is supported in part by the elbows- gynecological or rectal exams
- devices used for positioning
- pillow-position extremities, props for turning, relieve pressure b/n bony prominences.
- trochanter rolls
- prevent external rotation of the head of the femur in the acetabulum
- hand rolls
- prevent hand contractures
- splints
- prevent or treat contractures of joints
- side rails
- positioning aid for clients
- trapeze bar
- positiong aid
- bed board (transfer board)
- lifting clients b/n bed and stretcher
- wedges
- positioning w/ turning, prop to take pressure off both sacrum and trochanter
- foot board
- prevent foot drop contractures, prevent friction and shear injuries from sliding down in bed
- cradle
- supports covers on bed to take pressure, weight off toes
- sandbags
- turning and positioning, immobilizing extremity