Positioning

Question 1

What is the position of comfort?

Answer 1

Position of contracture

Question 2

Therapeutic positioning

Answer 2

Positioning for maximizing tissue and joint function

Question 3

Positioning is done for

Answer 3

Patient comfort
Therapeutic benefit
Pressure relief
Joint integrity

Question 4

Contracture Concerns

Answer 4

Limit function
Hygiene
Introduce skin or tissue compromise

Question 5

Pressure Relief Goal

Answer 5

Disperse pressure

Question 6

Risk Factors for Pressure Problems

Answer 6

Level of independence
Orientation/level of consciousness
Continence
Sensory function
Nutrition

Question 7

Pressure Problem Risk Areas

Answer 7

Bony prominences
Sacrum
Occipital tuberosity
Post calcaneus

Question 8

Braden Risk Assessment

Answer 8

Used by nurses for skin assessment

Question 9

6 Areas of Braden Assessment

Answer 9

Sensory perception
Moisture
Activity
Mobility
Nutrition
Friction/shear

Question 10

Foundation of Positioning

Answer 10

2 hour - alternating position
Alleviate pressure
Correct flexible vs accommodating fix deformity

Question 11

High Risk Contracture Areas

Answer 11

Knee and hip flexion
PF
Neck rotation
Shoulder extensors/adductor/IR’s

Question 12

Amputation Positioning

Answer 12

Offset prolonged sitting with prone (20-30 min, 3x/day)

No knee flexion in bed

Question 13

AKA Amputation Focus

Answer 13

Hip extension and adduction

Question 14

BKA Amputation Focus

Answer 14

Hip and knee extension

Question 15

Neuro Positioning

Answer 15

To normalize tone
Prevent/accommodate contracture
Stretch shortened structures

Question 16

Wound/Burn Positioning

Answer 16

Require special attention
Wound tissue shorten -> position for scar elongation
Greatest risk where scars are across/extend past joint

Question 17

Restraint

Answer 17

Device that is intended for medical purposes and limits the patient’s movements to the extent necessary for treatment

Question 18

Restraint Characteristics

Answer 18

Includes anything that the patient can’t move on their own

For patients with mobility deficits and fall risk

Question 19

Chemical/Pharmacologic Restraints

Answer 19

Medications to control behavior

Question 20

Physical Restraints

Answer 20

Anything that limits movement, restricts freedom of movement or normal access to one’s body

Question 21

Restraint Rules

Answer 21

Requires physician’s order, renewed every 24 hours
Face-to-Face evaluation every hour
Exhausted restraint alternatives
Does not include devices for the purpose of conducting routine physical examinations, tests, or procedures or to protect the patient from falling out of bed, or to permit the patient to participate in activities w/out the risk of physical harm
Use the least restrictive and safest restraint, follow protocol
Validate continued use of restraints
Don’t use sheets or gait belts as restraints