Turning and Positioning, Bedpan & Transfers

Question 1

Why do we turn and position our patients?

Answer 1

Maintain proper body alignment

Comfort

Joint mobility

Increase circulation by relieving pressure especially over bony prominences

Mental stimulation

Improve respiratory status

Question 2

How often do we turn and position?

Answer 2

At least every 2 hours based on research showing that lack of circulation to cells starts to cause damage at 2 hours (evidenced based practice)

Question 3

Who do we turn and position?

Answer 3

Clients who are immobile, paralyzed, comatose, experiencing decreased sensation or too weak to move themselves.

Question 4

Where should lift mat cover?

Answer 4

From shoulders to thigh

Question 5

How do you apply and use the (Pink) Friction Reducing Device?

Answer 5

-Gets placed underneath patient AND lift mat
-Should Cover surface of lift mat (which should be covering shoulder to thigh)
Procedure:
-Roll patient to a side
- Fold up plastic so that it’s as close to the patient as possible WHILE other side still touches side of bed
- Roll patient to opposite side
- Pull plastic sheet through
- Check and adjust, if necessary

Question 6

How do you position someone with hip surgery?

Answer 6

(Supine) Place pillow in between legs and trochanter roll on side of operated hip

Question 7

How and why do you treat hands for a bedridden shift?

Answer 7

Put towel roll into hands to prevent nails growing in

Question 8

What is the low-fowler’s position?
Uses and problems?

Answer 8

15-30 degrees
Specific Uses: Decreases intracranial pressure, maintains perfusion
General Fowler uses: Sleeping with breathing problems, prevent Upper body swelling post-op

Problems: Pressure injuries (Heels, shoulders, spine, coccyx)

Question 9

What is the semi-fowler’s position?
Uses and problems?

Answer 9

30-45 degrees
Uses: For suctioning, enteral feedings
General Fowler uses: Sleeping with breathing problems, Post-op (prevent swelling)

Problems: Pressure injuries (Heels, shoulders, spine, coccyx)

Question 10

What is the fowler’s position?
Uses and problems?

Answer 10

45-60 degrees
Specific uses: Eating/drinking, eases breathing for respiratory conditions
General Uses: Similar to low/semi

Problems: Pressure injuries (Heels, shoulders, spine, coccyx)

Question 11

What is the High Fowler’s position?
Uses and problems?

Answer 11

60-90 degrees
Specific uses: Nasogastric tube insertion, if patient has autonomic dysreflexia after T6 spinal cord injury (helps to drop blood pressure)
General Uses: Same as other Fowler’s
Problems: Pressure injuries (Heels, sacral/coccyx, shoulders, spine)

Question 12

How do you move a patient to a stretcher?

Answer 12

-Have Friction Reducing Device (FRD) under patient, if necessary
-Move patient closer to side of bed they will be transferred to
- Roll FRD and Lift mat closer to patient TOGETHER
-Turn patient to opposite side
-Place transfer board on back side of patient, partially onto stretching
- Underneath lift mat and FRD
-Return patient to supine
-Move stretcher closer and raise bed
-Slide patient onto stretcher
- With JUST lift mat
- Pull up stretcher side rail

Question 13

Describe Supine uses and problems

Answer 13

Uses: Sleeping, AFTER lumbar puncture, abdominal surgery
Problems: Pressure injuries (Heel, hip, elbow, scapula, back of head)

Question 14

Describe prone, uses and problems?

Answer 14

Uses: Helps with respiratory problems (ARDS, COVID), eases workload on heart, moves secretion
Problems: Must monitor airway stay open, eye damage, brachial plexus injury

Question 15

What is the dorsal recumbent position?
Uses and problems?

Answer 15

-Supine, knees bent
Uses: Foley catheter insertion on female, peri-care
Problems: Pressure injuries (heel, sacral/coccyx, elbow, shoulder, back of head)

Question 16

What is the Lithotomy position?
Uses and problems?

Answer 16

• Supine, legs flexed 90 degrees at hip; legs in stirrups
  Uses: Genitourinary system surgeries (Remove urinary stones, childbirth, vaginal exams)
  Problems: Pressure injuries (heel, sacral/coccyx, elbow, shoulder, back of head) AND nerve damage from stirrups

Question 17

Describe Sims’ / Semi-prone Position
Uses and Problems?

Answer 17

Lays on LEFT side; front knee and hip flexed, back knee and hip extended
Uses: Sleeping, foley catheter insertion, enema administration
Problems: Pressure injuries (ear, greater trochanter, sides of heel/ankle)

Question 18

Describe the Lateral position.
Uses and problems?

Answer 18

Place pillows at: Knees, ankle, elbow AND behind back to prevent rollover
- (Can place 1 pillow vertically for knee and ankle)
Uses: Seizures, unconscious, prevent aspiration, keep airway open
Problems: Pressure injuries (ear, shoulder, elbow, hip, knees and heels), damage to brachial plexus

Question 19

What is Trendelenberg position?
Uses and problems?

Answer 19

• Supine, head lowered, feet elevated
  Uses: Central venous catheter placement/removal, pelvic surgeries
  Problems:

Question 20

What is Reverse Trendelenberg?
Uses and problems?

Answer 20

• Supine, head elevated, feet lowered
  Uses: Surgery of head and neck (decrease blood flow & blood loss), closed cervical traction
  Problems:

Question 21

What is Modified trendelenberg?
Uses and problems

Answer 21

• Supine, upper body flat, feet elevated
  Uses: Increase venous return for hemodynamic problems