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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 23
Body Mechanics, Positioning,
and Moving
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
•Is the following statement true or false?
Good bod...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
True.
Good body posture distributes gravity through...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction to Dangers of Inactivity
• Inactivity ...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Dangers of Inactivity
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Good posture affects a person’s appearance,
stami...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Maintaining Good Posture (cont’d)
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Standing Posture
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
•Which type of mattress provides
minimal p...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
c. Egg-crate foam
Egg-crate foam mattress pr...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Sitting Posture
• Correct sitting posture
– Buttock...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Good lying-down posture
– Head, neck centered bet...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Body Mechanics
• Proper body mechanics
– Increase m...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Ergonomics
• Definition: special field of engineeri...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Positioning Clients
• General principles for positi...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Common positions
– Supine position
o Foot drop: p...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Foot Drop
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Positioning Clients (cont’d)
• Common positions (co...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Common Positions
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
•In what position should the infant be
pla...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
b. Supine
The infant should be placed in sup...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Positioning devices
– Adjustable bed
– Mattress
–...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Adjustable Bed
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Turning and moving clients
– Assistive devices an...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trochanter Rolls
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Hand Rolls
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Foot Boards, Boots, and Foot Splints
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Trapeze
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
•Which positioning device is foundational
...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
a. Mattress
A positioning device foundationa...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Protective/Pressure-Relieving
Devices
• Side rails
...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Protective/Pressure-Relieving
Devices (cont’d)
• Cr...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Oscillating Bed
• Slowly, continuously rocks from s...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Circular Bed
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Transferring Clients
• Examples of transferring aid...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Nursing diagnoses for inactive clients
– Impaired...
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
• Older adults
– Need to maintain as much mobility ...
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  1. 1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 23 Body Mechanics, Positioning, and Moving
  2. 2. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins •Is the following statement true or false? Good body posture distributes gravity through the center of the body over a wide base of support. Question
  3. 3. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins True. Good body posture distributes gravity through the center of the body over a wide base of support. A poor posture often results in muscle spasms. Answer
  4. 4. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Dangers of Inactivity • Inactivity leads to deterioration of health – Disuse syndrome: signs and symptoms resulting from inactivity in a short amount of time
  5. 5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Dangers of Inactivity
  6. 6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Good posture affects a person’s appearance, stamina, and ability to use the musculoskeletal system efficiently • Poor posture often results in muscle spasms Maintaining Good Posture
  7. 7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Maintaining Good Posture (cont’d)
  8. 8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Standing Posture
  9. 9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Which type of mattress provides minimal pressure reduction? a. Water b. Static air c. Egg-crate foam d. Gel
  10. 10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer c. Egg-crate foam Egg-crate foam mattress provides minimal pressure reduction. A water mattress supports the body and equalizes the pressure per square inch over its surface. A static air pressure mattress suspends the client on a buoyant surface, distributing the pressure on the underlying tissue. Gel is an alternative substance used to fill cushions and mattresses.
  11. 11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Sitting Posture • Correct sitting posture – Buttocks and thighs base of support – Both feet rest on floor – Knees bent and clear of chair edge (Refer to Figure 23-3 in the textbook.)
  12. 12. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Good lying-down posture – Head, neck centered between shoulders – Shoulders level; arms, hips, knees slightly flexed – Trunk straight; hips level; legs parallel; feet at right angles to legs (Refer to Figure 23-4 in the textbook.) Lying-Down Posture
  13. 13. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Body Mechanics • Proper body mechanics – Increase muscle effectiveness – Reduce fatigue – Avoids repetitive strain injuries
  14. 14. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Ergonomics • Definition: special field of engineering science devoted to the promotion of comfort, performance, and health in the workplace – Example: using assistive devices to lift or transport heavy items or clients; using alternative equipment for repetitive tasks
  15. 15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients • General principles for positioning – Change the inactive client’s position at least every 2 hours – Enlist the assistance of at least one other caregiver – Remove pillows and positioning devices
  16. 16. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Common positions – Supine position o Foot drop: permanent dysfunctional position caused by shortening of the calf muscles and lengthening of the opposing muscles on the anterior leg Positioning Clients (cont’d)
  17. 17. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Foot Drop
  18. 18. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients (cont’d) • Common positions (cont’d) – Lateral – Lateral oblique – Prone – Sims’ and Fowler’s
  19. 19. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Positions
  20. 20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •In what position should the infant be placed to reduce the incidence of sudden infant death syndrome? a. Lateral b. Supine c. Prone d. Sims’
  21. 21. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer b. Supine The infant should be placed in supine position to reduce the incidence of sudden infant death syndrome. Lateral position, prone position, and Sims’ position are not recommended to reduce sudden infant death syndrome.
  22. 22. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Positioning devices – Adjustable bed – Mattress – Bed board (rigid structure placed under a mattress) – Pillows – Roller sheets Positioning Clients (cont’d)
  23. 23. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Adjustable Bed
  24. 24. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Turning and moving clients – Assistive devices and additional caregivers are needed when turning or moving a client who cannot change from one position to another independently Positioning Clients (cont’d)
  25. 25. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Trochanter Rolls
  26. 26. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Hand Rolls
  27. 27. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Foot Boards, Boots, and Foot Splints
  28. 28. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Trapeze
  29. 29. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Which positioning device is foundational for good body alignment? a. Mattress b. Adjustable bed c. Pillow d. Roller sheet
  30. 30. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer a. Mattress A positioning device foundational for good body alignment is a mattress. Adjustable beds allow changes in head and knee position. Pillows are used to support and elevate a body part. A roller sheet that extends from the upper back to midthighs is used to slide and roll the client.
  31. 31. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective/Pressure-Relieving Devices • Side rails • Mattress overlays – Foam and gel mattresses – Static air mattress – Alternating air mattress – Water mattress
  32. 32. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective/Pressure-Relieving Devices (cont’d) • Cradle: metal frame secured to or placed on top of the mattress to protect feet and lower legs from bed linens • Specialty beds – Low air loss – Air fluidized – Oscillating support – Circular bed
  33. 33. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Oscillating Bed • Slowly, continuously rocks from side to side in 124-degree arc – Relieves skin pressure – Helps mobilize respiratory secretions (Refer to Figure 23-18 in the textbook.)
  34. 34. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Circular Bed
  35. 35. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Transferring Clients • Examples of transferring aids – Transfer handle – Transfer belt – Transfer boards – Mechanical lift
  36. 36. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Nursing diagnoses for inactive clients – Impaired physical mobility – Risk for injury – Risk for disuse syndrome – Risk for perioperative-positioning injury – Impaired bed mobility Nursing Implications
  37. 37. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • Older adults – Need to maintain as much mobility as possible to prevent disability – Require extra time and assistance during positioning, transferring, and ambulating – Instructions should be given using clear, simple words; make one request at a time General Gerontologic Considerations
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