Turning and Positioning, Bedpan & Transfers Flashcards
Why do we turn and position our patients?
Maintain proper body alignment
Comfort
Joint mobility
Increase circulation by relieving pressure especially over bony prominences
Mental stimulation
Improve respiratory status
How often do we turn and position?
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)
Who do we turn and position?
Clients who are immobile, paralyzed, comatose, experiencing decreased sensation or too weak to move themselves.
Where should lift mat cover?
From shoulders to thigh
How do you apply and use the (Pink) Friction Reducing Device?
-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
How do you position someone with hip surgery?
(Supine) Place pillow in between legs and trochanter roll on side of operated hip
How and why do you treat hands for a bedridden shift?
Put towel roll into hands to prevent nails growing in
What is the low-fowler’s position?
Uses and problems?
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)
What is the semi-fowler’s position?
Uses and problems?
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)
What is the fowler’s position?
Uses and problems?
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)
What is the High Fowler’s position?
Uses and problems?
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)
How do you move a patient to a stretcher?
-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
Describe Supine uses and problems
Uses: Sleeping, AFTER lumbar puncture, abdominal surgery
Problems: Pressure injuries (Heel, hip, elbow, scapula, back of head)
Describe prone, uses and problems?
Uses: Helps with respiratory problems (ARDS, COVID), eases workload on heart, moves secretion
Problems: Must monitor airway stay open, eye damage, brachial plexus injury
What is the dorsal recumbent position?
Uses and problems?
-Supine, knees bent
Uses: Foley catheter insertion on female, peri-care
Problems: Pressure injuries (heel, sacral/coccyx, elbow, shoulder, back of head)
What is the Lithotomy position?
Uses and problems?
- 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
Describe Sims’ / Semi-prone Position
Uses and Problems?
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)
Describe the Lateral position.
Uses and problems?
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
What is Trendelenberg position?
Uses and problems?
- Supine, head lowered, feet elevated
Uses: Central venous catheter placement/removal, pelvic surgeries
Problems:
What is Reverse Trendelenberg?
Uses and problems?
- Supine, head elevated, feet lowered
Uses: Surgery of head and neck (decrease blood flow & blood loss), closed cervical traction
Problems:
What is Modified trendelenberg?
Uses and problems
- Supine, upper body flat, feet elevated
Uses: Increase venous return for hemodynamic problems
