Positions Flashcards
What are contractures and what causes them ?
Joint and muscle rigidity caused by multiple reasons :
- from staying in the same position for too long
- nerve damage
- muscular dystrophy
What are pressure injuries and what causes them ?
Injuries of the skin and tissue due to prolonged pressure on the skin
Why do we change the client’s position by turning them at least every 2 hours ?
It helps to :
- Prevent pressure ulcers (decubitus ulcers/ bed sores)
- Prevent pneumonia by breaking up mucus secretions in lungs
- Prevent contractures
What does HOB mean ?
Head of Bed
HOB refers to the position that the head of the bed is in.
Example: “HOB elevated” or “HOB flat”
What is the most common position to place a client ?
Fowler’s position: HOB is elevated. This position prevents pressure of the diaphragm on the lungs and heart to promote breathing. It is common with cardiac and respiratory diseases
Describe the HOB elevation in degrees for each Fowler position:
- low-Fowler’s
- semi-Fowler’s
- standard Fowler’s
- high Fowler’s
- low-Fowler: HOB elevated 15 - 30 degrees
- semi-Fowler’s: HOB elevated 30 - 45 degrees
- standard Fowler’s: HOB elevated 45 - 60 degrees
- high-Fowler’s: HOB elevated 60 - 90 degrees
What position is supine ?
On the back
What position is prone ?
On the stomach
What position is semi-prone or sim’s ?
Forward side-lying
What position is right lateral recumbent ?
On the right side
What position is left lateral recumbent ?
On the left side
What position is lithotomy ?
On the back with legs apart
What position is Trendelenburg ?
Supine with head lower than the feet
What position is reverse Trendelenburg ?
Supine with head higher than the feet
What position is best after a cardiac catheterization?
Supine with legs straight for 2 - 6 hours afterwards
This prevents bleeding and promotes good circulation. If a closing device is used may only need to be supine for 1 - 2 hours
What position is best during and after tube feedings ?
Semi-Fowler’s: HOB elevated at least 30 degrees
This prevents aspiration.
What position is best after a liver biopsy ?
On the right side with pillow splint for 2 hours.
This is to prevent bleeding since the liver is vascular and on the right side.
What position is best during a thoracentesis ?
There are two positions :
- Leaning over the bedside table
- In bed with the affected side up
This is to promote separation of the ribs in order to reach the pleural space better and to get the excess fluid out.
What position is best with most neurological problems ?
Semi Fowler’s: HOB elevated and head midline
This is to prevent increased intracranial pressure and promote blood flow to the brain
How should a client with spinal cord injuries be moved ?
Logroll
Keep the head in midline with the rest of the body when moving.
This is to prevent additional spinal injuries.
What position is best for varicose veins ?
Keep veins elevated by having the legs up to prevent swelling.
This is to promote blood circulation because the valves of the veins are not strong enough to move the blood back to the heart.
What position for the legs is best for peripheral arterial disease ?
Dangle arteries by keeping the legs down.
This is to promote blood circulation because the arteries are hardening making them stiff and unable to dilate well.
What is the best position after a hip replacement ?
Legs abducted (apart) using a wedge pillow, avoid hip flexion > 90 degrees
Prevents the hip from dislocating.
Remind the patient: no bending over, no sitting on a low toilet
What is the best position after an amputation ?
Elevate extremity for 24 hours post-op
This is to prevent edema.
