Safely Lifting, Moving, and Positioning Patients Flashcards
Overview of the Structure and Function of
the Musculoskeletal System (cont’d)
Striated muscles surrounded by a connective tissue sheath;
muscles, hamstring muscles and abdominal muscles are all examples of
skeletal muscles.There are skeletal muscles throughout the body,
located between bones.
* Tendon- Connect your muscles to the bones; let you move your
limbs. Fibrous tissue that connects muscle to bone to allow for
joint movement.
* Ligament
* Connects bone to cartilage to provide support and strength.
* Cartilage
* Fibrous connective tissue; acts as a cushion.
Types of Bones
Long bones- are longer than they are wide and the muscle act on then as rigid levers.
Functions of Bones***
Functions
of
Bones***
➔ Provide a scaffolding to
support the body
➔ Give shape to the
body and support
the internal organs
and skin
➔ Provide places for
ligaments and tendons to
attach to facilitate
movement.
➔ Joints allow movement
and flexibility of the
skeleton
Functions of Muscles***
Can stretch; can be stimulated to
contract electrically or to extend
elastically
Provide movement
Stabilize joints
Produce heat
Maintain posture
Changes Occurring with Aging
Bone mass loss may lead
to osteoporosis (more
severe in women)
➔ Loss of bone density
predisposes the elderly to
fractures.
➔ Muscle cells are lost and
replaced by fat cells.
➔ Elasticity of muscle
fibers is decreased,
limiting flexibility.
➔ Joint motion may decrease,
limiting motion and
Principles of Body Movement for Nurses
One of the most common injuries in health care workers is lower back
strain.
❖ Get help whenever possible; ask patient to help if able.
❖ Encourage patient to assist when transferring and moving if possible.
❖ Use thigh, arm, or leg muscles rather than back muscles, and use a
wide base of support.
Principles of Body Movement for Nurses (cont’d)
Provide stability for movement
○ Keep feet approximately shoulder-width apart
○ Use the greatest number of muscles possible
● Use smooth, coordinated movements
● Keep loads close to the body
● Keep loads near the center of gravity
● Pull and pivot, using smooth, coordinated
movements; avoid jerking or sudden pulling
movements
Moving and Lifting Patients***
Two basic principles ***
* Maintain correct anatomic position
* Change position frequently
* Hazards of improper alignment and positioning
* Interference with circulation, which may lead to pressure
ulcers.
* Muscle cramps and possible contractures.
* Fluid collection in the lungs.
Pressure Injury
Previously known as decubitus ulcers,
or bedsores, pressure ulcers.
Occur when pressure on the skin
causes an area of local tissue necrosis
Occur most often between a bony
prominence and an external surface
May be caused by shearing as force is
applied downward and forward on
tissue beneath the skin (as when a
patient slides down in a chair)
Application
of the
Nursing
Process:
Assessment
(Data
Collection)
When assessing the patient’s standing body alignment,
start by noting the head position in relation to the rest
of the body
Start by
When assessing the sitting patient, observe for
symmetry Observe
When assessing the lying patient, assess carefully for
alignment and correct position Assess
Assess the patient’s ability to ambulate (walk) and to
change position independently Assess
Observe Observe the patient walking
Application
of the
Nursing
Process:
Nursing
Diagnosis
Commonly used nursing
diagnoses
* Risk for injury
* Impaired physical mobility
* Risk for impaired skin
integrity
* Impaired walking
Application of the Nursing
Process: Planning
- Decide how to change the patient’s position
and whether you can delegate this task to
assistive personnel. - The home setting must also be considered
when planning care for the patient.
- When moving a patient, it is
important to use proper body
mechanics. Which of the following
is not a proper body mechanic?
D. Keeping loads as well as your
elbows close to the body.
Leann is teaching her patient’s
husband how to lift his wife
safely. Which of the following is
true regarding lifting the elderly?
D. Joint motion may decrease,
limiting mobility
Lifting, Moving, and Positioning Patients
Lifting, Moving, and Positioning Patients
*Theory
* 5) Describe the proper method for transferring a patient between
wheelchair and bed.
Lifting, Moving, and Positioning Patients
* Clinical Practice
* Correctly position a patient in the following
positions: supine, prone, Fowler, and Sims
* Assist patients to sit up in bed
* Demonstrate complete passive range-of-motion
(ROM) exercises for a patient
* Correctly transfer a patient from a wheelchair to a bed
* Transfer a patient from a bed to a stretcher
* Demonstrate the correct techniques for ambulating a patient and
for breaking a fall while ambulating
Application of the Nursing Process:
Implementation: Positioning
Accomplishes four objectives
Positioning provides comfort
Positioning relieves pressure on bony prominences and other parts,
decreasing the patient’s risk of developing bedsores
Positioning prevents contractures, deformities, and respiratory
problems
Positioning improves circulation
Common Positions and
Variations: Supine
Patient lying on her back
* Fowler’s position
* Supine with the HOB elevated 60 to 90 degrees
* Semi-Fowler’s position
* Supine with the HOB elevated 30 to 60 degrees
* Low Fowler’s position
* Supine with the HOB elevated 15 to 30 degrees
Common Positions and
Variations: Supine***
Dorsal recumbent position
* Supine with knees flexed and feet flat on the
bed;
* used for many procedures and examinations.
- Dorsal lithotomy position
- Feet in stirrups and legs spread farther
apart; used in pelvic exams
Common Positions and Variations: Side-Lying Lateral
Patient lying on her side
* Alleviates pressure on bony prominences of the
* back
* Oblique side-lying position
* Removes pressure from shoulder and hip
* Easier for patients
* Sims’ position
* A variation of side-lying used for rectal
examinations or insertions of tubes or
suppositories
Common Positions and
Variations: Prone
Patient lying face-down * Often used for patients with
spinal cord injury
* Not generally well-tolerated * Knee-chest position * Face down, with chest,
knees, and elbows resting
on the bed
* Used for rectal
examinations
Common
Positioning
Devices***
Pillows
Used to support
the body or
extremities
Boots or splints Maintain
dorsiflexion
Footboards,
high-top
sneakers
Maintain
dorsiflexion
Trochanter
Common
Positioning
Devices
(cont’d)
- Used to immobilize an extremity, p
- provide support, and maintain body
alignment
Sandbags - Help prevent contractures and prevent
dorsiflexion of the wrist
Hand rolls - Enhance patient mobility, provide patient
safety, and support
Moving Patients Up in Bed
- Using a lift sheet
- Requires at least two people standing on opposite
sides of the be. - Both face the bed and use the sheet to move the patient
up in the bed. - Moving the patient is performed as a coordinated effort.
- Patient is lifted and moved, not dragged.
Logrolling
Turning the patient as a single unit.
* Body alignment maintained at all times.
* Used to change bed linen, can be performed
with or without a lift sheet.
* Requires two people if patient cannot turn
herself.
* Leave a pillow under the patient’s head.
