Patient positioning Flashcards
List 6 basic patient positions
- supine (dorsal decubitus) 2. prone (ventral decubitus) 3. lateral decubitus 4. lithotomy 5. beach chair (sitting)
what are the pressue points in supine position?
occiput scapulae elbows wrists sacrum calves heels
Where do you tuck the draw sheet if you tucking the arm?
under the patient’s hip
True or false. You should restrain the arms on the arm board when the patient is in the supine position
True
what type of pillow do you use when the patient is lying prone?
head or proneview pillow – make sure neck is neutral
what should be procected from excessive pressure when in the prone position?
eyes upper extremities breasts/genitals hips
what cardiovascular changes occur with positioning from erect to supine?
increases — CO, SV, End organ perfusion, venous return
decreases — MAP, HR, SVR (systemic vascular resistance)
what respiratory changes occur when changing position from erect to supine?
decreases FRC
Increase dead space
changes in compliance, V/Q mismatch, diaphragm position
What are complications of venous statsis?
DVT
monoccular blindness
What are some complicatinos of supine position?
posteral hypotension
pressure alopecia
pressure point reactions (compression and ischemia)
ulnar nerve injury
brachial plexus injury
what are some complications r/t the lateral decubits position?
damage to eyes or ears
neck injury (lateral flexion)
suprascapular nerve injury
long thoracic nerver injury
in the sitting position where would MAP be measured?
at the level of circle of willis (transducer placed at the level of external ear canal)
what are logistic concerns of prone position?
risks are
accidental extubation,
loss of vascular access lines, catheters, & monitors;
& accentuation of multiple trauma.
What are complication associated with prone position?
damage to the eyes (blindness)
neck injury
breast injury
brachial plexus injuries
How should the trunk of the body be supported in prone position?
The chest is supported on long cushions or on a longitudinal support frame, allowing as much diaphragmatic & abdominal movement with ventilation as possible
How are the legs positioned in lateral decubitus position?
bottom leg flexed
top leg straight
pillow between
what is used to prevent brachial plexus injury and ensure perfusion of decubitus side when in the lateral decubitus position?
axillary roll
What is the position in which the patient is on their back with the hips extened 90o & knees flexed & the thighs apart
lithotomy
True or False. When positioning for lithotomy position the patient’s legs should be put into the stirrups one at atime.
False. shoud place then simultaneously
What are complications of lithotomy position?
increase pressure in abdomen and thoraci areas
lower limb nerve injuries (sciatic and common fibular (peronal)
….
what is purpose of trendelenburg position?
increase venous return during hypotension
improve exposure during abdominal and laproscopic surgery
prevent air emboli & facilitate cannulation during central line placement
what are cardiovascular effects of trendelenburg position?
Increases CVP
Increases ICP
Increases IOP
Swelling of face, conjunctiva, trachea, and tongue (prolonged head down)
what are pulmonary effects of trendelenburg?
decrease FRC
decrease compliance
increase work of breathing (spont. breathing)
increase intrathoracic pressure (harder to ventilate)
what are some cautions of using reverse trendelenburg (head up)?
possible to slide off the table
decrease venous return (hypotension)
more frequent arterial pressure readings to ensure perfusion of brain (level of circle of willis)
