Range of Motion,
Body Mechanics,
Transfers &
Positioning ,
comfort devices
 Activity of daily living(ADL) refers activities that
require energy expenditure such as hygiene,
dressing, cooking, shop...
Normal movement
 Body movement requires coordinated muscle activity
and neurologic integration.
 It require four basic e...
 Line of gravity: An imaginary vertical line drawn
through the body’s center of gravity.
 Center of gravity: the point a...
Center of
gravity
Activity and Exercise
 Activity-exercise pattern: Refers to a person’s
routine of exercise, activity, leisure and recreat...
Types of exercise:
 Isotonic (dynamic) exercises:
Muscle shortens to produce contraction and active movement
.e.g. runnin...
Types of exercise:
 Isokinetic (resistive) exercises:
 It involves muscle contraction or tension against
resistance, can...
GENERAL CONSIDERATIONS FOR PERFORMING
PHYSICAL TASKS
 Keep the work as close as possible to your body. It
puts less of a ...
Range of Motion
 ROM is the extent of
movement that a joint
is normally capable of.
TYPES OF ROM EXERCISES
 Passive range-of-motion exercises
 PROM
 Active range-of-motion exercises
 AROM
 Active-Assis...
Passive ROM
 The patient is unable
to move
independently and
someone else
manipulates body
parts.
Active ROM
 The patient moves
independently through a
full ROM for each joint.
Only active ROM increases
muscle tone, mas...
Active-Assistive ROM
The nurse provides minimal support as the patient
moves through ROM.
Hand Movements (ROM)
 ROM in wrist includes
flexion, extension,
radial & ulner
deviation
 ROM in hands include
abduction...
Hip ROM
Hip ROM includes
flexion, extension and
lateral & external
rotation
 Adduction &
Abduction
Factors That Affect Body Alignment
and Mobility
1. Growth & Development---Age of Client
2. Nutrition (under nutrition, Ove...
Effects of immobility
Musculoskeletal system:
 Disuse osteoporosis: calcium depleted bone become
spongy deform and fractu...
Effects of immobility
Respiratory system:
 Decreased respiratory movement
 Pooling of respiratory secretions
 Atelectas...
Effects of immobility
Urinary system:
 Urinary stasis
 Renal calculi
 Urinary retention
 Urinary infection
Gastrointes...
Effects of immobility
Integumentary system
 Reduced skin turgor
 Skin breakdown
Psycho neurologic system
 Lower self es...
Body mechanics
Introduction:
Some of the most common injuries sustained by
members of the health care team are severe
musc...
MASS
: Quantity of Atoms
VELOCITY
: Speed of movement
ACCELERATION
: a positive rate of change in velocity
DECELRATION
: a...
DEFINITION
 Body mechanics is the utilization of correct muscles
to complete a task safely and efficiently, without
undue...
Use proper body mechanics in order
to avoid the following:
 Excessive fatigue.
 Muscle strains or tears.
 Skeletal inju...
PRINCIPLES OF GOOD BODY MECHANICS
1. Maintain a Stable Center of Gravity.
Keep your center of gravity low. Keep your back
...
Body Alignment
Balance: Keep Your Feet 12” apart
PRINCIPLES OF GOOD BODY MECHANICS
contd……..
3. Maintain the Line of Gravity.
The line should pass vertically through the b...
When sitting keep your back straight.
X
TECHNIQUES OF BODY MECHANICS
 Lifting:
Use the stronger leg muscles for lifting. Bend at the
knees and hips; keep your ba...
TECHNIQUES OF BODY MECHANICS
 Pivoting
Place one foot slightly ahead of the other.
Turn both feet at the same time, pivot...
GENERAL CONSIDERATIONS FOR
PERFORMING PHYSICAL TASKS
 It is easier to pull, push, or roll an object than it is to
lift it...
STEPS INVOLVED IN PROPERLYMOVING AN
OBJECT TO A NEW LOCATION
The process of moving (lifting, pivoting, squatting, and
carr...
STEPS INVOLVED IN PROPERLYMOVING AN
OBJECT TO A NEW LOCATION
 Identify the object to be moved.
 Adopt a stable base of s...
STEPS INVOLVED IN PROPERLYMOVING AN
OBJECT TO A NEW LOCATION
 Re-establish your base of support and appropriate
body alig...
STEPS INVOLVED IN PROPERLYMOVING
AN OBJECT TO A NEW LOCATION
 Re-establish a stable base of support and appropriate
body ...
Second session
Positioning
Clients
Positions and Uses
 Dorsal (supine):
* Place patient on back with head and shoulders are slightly elevated.
* Used for ph...
Positions and Uses
 Dorsal recumbent:
* Place patient on back, legs flexed and slightly rotated outward
*Used for pelvic ...
Positions and Uses
 Semi-fowler’s position:
* Sitting position with or without positioning pillow at head 45-60
degree. u...
Positions and Uses
 High fowler’s position:
*Head & trunk are raised 60-90 degrees, used for some people with
heart probl...
Positions and Uses
Prone position:
* Lying flat on the abdomen, arm flexed toward head, & head turned to
one side. Useful ...
Side-lying Position
 Major weight on
dependant hip and
shoulder.
 Use supportive foam
blocks or pillows for
support
Sims Position
 Weight supported by
anterior aspects of
humerus, clavicle and
ileum.
 These pressure points
are different...
Positioning and Ambulating the Adult Patient
 One of the basic procedures that nursing personnel
perform most frequently ...
REASONS FOR CHANGING THE
POSITION OF A PATIENT
The following are reasons for changing a
patient's position.
 To promote c...
REASONS FOR CHANGING THE
POSITION OF A PATIENT
 To prevent deformities. When one lies in bed for long
periods of time, mu...
BASIC PRINCIPLES IN POSITIONING OF
PATIENTS
 Maintain good patient body alignment. .
 Maintain the patient's safety.
 R...
BASIC PRINCIPLES IN POSITIONING OF
PATIENTS
 Keep in mind proper body mechanics for the
practical nurse. Obtain assistanc...
TURNING THE ADULT PATIENT
General Principles for Turning the Adult
Patient .
 Sometimes the physician will specify how of...
Turning a Patient
 Determine what patient can do, find assistance if it is
needed.
 Position height of bed for nurses’ c...
Positioning/Moving a Client Up in Bed
 Allow patient to move himself if he can.
 HOB down---don’t move up hill.
 Positi...
Use Mechanical Devises
 Lifts will save backs,
yours included.
1.PILLOWS:
 Used for support to
maintain correct body
alignment Used under
head, arms, legs & along
spine or abdomen
 Co...
COMFORT DEVICES
 Support pts back at an angle, so that he may maintain a sitting
position Can be adjusted to desired angl...
Comfort device contd……
 3.BED CRADLE
Is a frame used to hold the
bed linen from touching the pt
•Used to prevent
pressure...
Comfort device contd……
4.CARDIAC TABLE
/ORTHOPNEIC/BED TABLE:
 Usually for pts who are propped up in a
sitting position f...
Comfort device contd……
5.MATTRESSES
2 types One that fits on bed frame.
Ex: standard bed mattress
Mattresses that fit on s...
6.BED BOARDS
Boards are usually made of wood & are placed
under the mattress to provide support
7.CHAIR BEDS
Beds can be placed into the position of chair for pts who
cannot move from the bed but require a sitting posi...
Comfort device contd……
8.TRAPEZE BAR
Bar is suspended from an
overhead frame that extends
from the foot to head of bed
Pt ...
9.FOOTBOARD
Device that is placed towards
the foot of pts bed to serve as
support for his feet Some fit
onto the sides of ...
Comfort device contd……
10.FRACTURE BOARD:
 Is a support that is placed under pts mattress to give
added rigidity to the m...
11.BALKAN FRAME :
Frame made of wood or metal that extends
lengthwise above the bed & is supported at either
ends by a pol...
Comfort device contd……
12.BRADFORD FRAME:
Is a canvas stretcher like device that is supported by
blocks on the foundation ...
Comfort device contd……
13.TROCHANTER ROLLS
 Prevent external rotation of legs when pt is in supine
position A cotton bath blanket/sheet is folde...
TROCHANTER ROLLS
Comfort device contd……
 Provide support & shape to body contours
Immobilize extremities &
maintain specific body
alignmen...
Comfort device contd
15.HAND ROLLS
 Maintain thumb in slightly
adducted & in opposition
to fingers
 Maintain fingers in ...
Comfort device contd……
 16.HAND-WRIST
SPLINTS
Individually molded for
the patient to maintain
proper alignment of
the thu...
17.SIDE RAILS
• Are bars positioned
along the sides of the
length of the bed
•Ensure pt’s safety & are
useful for increasi...
Comfort device contd…..
18.WEDGE/ABDUCTOR PILLOW
 Is a triangular
shaped pillow made
of heavy foam
 Used to maintain leg...
WEDGE/ABDUCTOR PILLOW
Nursing Diagnoses
 Activity Intolerance
 Impaired Physical Mobility
 Risk of Disuse Syndrome
 Self-Care Deficits
 Alt...
Planning and Outcome Identification
 Bed Rest
 Restorative Nursing Care (Changing position)
 Health Promotion and Fitne...
Assisting with Ambulation
 Assistive Devices
-Canes -Crutches -Walkers
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Activity &exercise

  1. 1. Range of Motion, Body Mechanics, Transfers & Positioning , comfort devices
  2. 2.  Activity of daily living(ADL) refers activities that require energy expenditure such as hygiene, dressing, cooking, shopping, eating, working, home maintenance.  Mobility refers the ability to move freely , easily, rhythmically and purposefully in the environment. .
  3. 3. Normal movement  Body movement requires coordinated muscle activity and neurologic integration.  It require four basic elements 1. Body alignment 2. Joint mobility 3. Balance 4. Coordinated movement
  4. 4.  Line of gravity: An imaginary vertical line drawn through the body’s center of gravity.  Center of gravity: the point at which all of the Body’s mass centered.  Base of support: the foundation on which the body rests
  5. 5. Center of gravity
  6. 6. Activity and Exercise  Activity-exercise pattern: Refers to a person’s routine of exercise, activity, leisure and recreation needs for rest and mobility.  Exercise: A type of physical activity involving the muscles performed to maintain or improve physical fitness.
  7. 7. Types of exercise:  Isotonic (dynamic) exercises: Muscle shortens to produce contraction and active movement .e.g. running, walking, swimming, cycling) * Advantages: 1- Increase muscle tone, mass, strength. 2- Maintain joint flexibility and circulation.  Isometric (static or setting) exercises: There is muscle contraction without moving the joint * useful for strengthening abdominal, gluteal muscles) * No change in muscle length * No joint movement * Maintaining strength in immobilized muscle
  8. 8. Types of exercise:  Isokinetic (resistive) exercises:  It involves muscle contraction or tension against resistance, can be either isotonic and isometric.  These exercises are used in physical conditioning & are often done to build up certain muscle groups.  Aerobic exercises:  Activities during which the amount of oxygen taken in to the body is greater than that used to perform the activity.
  9. 9. GENERAL CONSIDERATIONS FOR PERFORMING PHYSICAL TASKS  Keep the work as close as possible to your body. It puts less of a strain on your back, legs, and arms.  Rock backward or forward on your feet to use your body weight as a pushing or pulling force.  Keep the work at a comfortable height to avoid excessive bending at the waist.  Keep your body in good physical condition to reduce the chance of injury
  10. 10. Range of Motion  ROM is the extent of movement that a joint is normally capable of.
  11. 11. TYPES OF ROM EXERCISES  Passive range-of-motion exercises  PROM  Active range-of-motion exercises  AROM  Active-Assistive range-of-motion exercises  AAROM
  12. 12. Passive ROM  The patient is unable to move independently and someone else manipulates body parts.
  13. 13. Active ROM  The patient moves independently through a full ROM for each joint. Only active ROM increases muscle tone, mass, strength and improves cardiac and pulmonary functioning
  14. 14. Active-Assistive ROM The nurse provides minimal support as the patient moves through ROM.
  15. 15. Hand Movements (ROM)  ROM in wrist includes flexion, extension, radial & ulner deviation  ROM in hands include abduction, adduction, flexion, extension, opposition and circumduction of the thumb.
  16. 16. Hip ROM Hip ROM includes flexion, extension and lateral & external rotation  Adduction & Abduction
  17. 17. Factors That Affect Body Alignment and Mobility 1. Growth & Development---Age of Client 2. Nutrition (under nutrition, Over nutrition) 3. Personal values and attitudes (family ,personal appearance) 4. External factors :high temperature and low humidity 5. Prescribed limitations: Bed rest ,advised for clients to relieve edema, pain reduce oxygen needs, to promote tissue repair
  18. 18. Effects of immobility Musculoskeletal system:  Disuse osteoporosis: calcium depleted bone become spongy deform and fracture easily.  Disuse atrophy(Decrease in size)  Contractures: permanent shortening of the muscle  Stiffness and pain in the joints :connective tissue immobile. Cardiovascular system:  Diminished cardiac reserve  Increased use of the valsalva maneuver  Orthostatic hypotension  Venous vasodilation and stasis  Dependent edema
  19. 19. Effects of immobility Respiratory system:  Decreased respiratory movement  Pooling of respiratory secretions  Atelectasis  Hypostatic pneumonia Metabolic system:  Decreased metabolic rate  Negative nitrogen balance  Anorexia  Negative calcium balance
  20. 20. Effects of immobility Urinary system:  Urinary stasis  Renal calculi  Urinary retention  Urinary infection Gastrointestinal system  Decreased peristalsis, constipation
  21. 21. Effects of immobility Integumentary system  Reduced skin turgor  Skin breakdown Psycho neurologic system  Lower self esteem(emotional reactions such as withdrawn, aggressive, regression)  Frustration  Anxiety
  22. 22. Body mechanics Introduction: Some of the most common injuries sustained by members of the health care team are severe musculoskeletal strains. Many injuries can be avoided by the conscious use of proper body mechanics when performing physical labor.
  23. 23. MASS : Quantity of Atoms VELOCITY : Speed of movement ACCELERATION : a positive rate of change in velocity DECELRATION : a negative rate of change in velocity FORCE : a push or pull TORQUE : The tendency of force acting at a perpendicular distance from an axis to rotate a lever system
  24. 24. DEFINITION  Body mechanics is the utilization of correct muscles to complete a task safely and efficiently, without undue strain on any muscle or joint.
  25. 25. Use proper body mechanics in order to avoid the following:  Excessive fatigue.  Muscle strains or tears.  Skeletal injuries.  Injury to the patient.  Injury to assisting staff members.
  26. 26. PRINCIPLES OF GOOD BODY MECHANICS 1. Maintain a Stable Center of Gravity. Keep your center of gravity low. Keep your back straight. Bend at the knees and hips. 2. Maintain a Wide Base of Support. This will provide you with maximum stability while lifting. Keep your feet apart. Place one foot slightly ahead of the other. Flex your knees to absorb jolts.(moving suddenly, violently) Turn with your feet
  27. 27. Body Alignment
  28. 28. Balance: Keep Your Feet 12” apart
  29. 29. PRINCIPLES OF GOOD BODY MECHANICS contd…….. 3. Maintain the Line of Gravity. The line should pass vertically through the base of support. Keep your back straight. Keep the object being lifted close to your body. 4.Maintain Proper Body Alignment. Tuck in your buttocks. Pull your abdomen in and up. Keep your back flat. Keep your head up. Keep your chin in. Keep your weight forward and supported on the outside of your feet.
  30. 30. When sitting keep your back straight. X
  31. 31. TECHNIQUES OF BODY MECHANICS  Lifting: Use the stronger leg muscles for lifting. Bend at the knees and hips; keep your back straight. Lift straight upward, in one smooth motion.  Reaching: Stand directly in front of and close to the object. Avoid twisting or stretching. Use a stool or ladder for high objects. Maintain a good balance and a firm base of support. Before moving the object, be sure that it is not too large or too heavy.
  32. 32. TECHNIQUES OF BODY MECHANICS  Pivoting Place one foot slightly ahead of the other. Turn both feet at the same time, pivoting on the heel of one foot and the toe of the other. Maintain a good center of gravity while holding or carrying the object. Avoid Stooping. Squat (bending at the hips and knees). Avoid stooping (bending at the waist). Use your leg muscles to return to an upright position.
  33. 33. GENERAL CONSIDERATIONS FOR PERFORMING PHYSICAL TASKS  It is easier to pull, push, or roll an object than it is to lift it.  Movements should be smooth and coordinated rather than jerky.  Less energy or force is required to keep an object moving than it is to start and stop it.  Use the arm and leg muscles as much as possible, the back muscles as little as possible
  34. 34. STEPS INVOLVED IN PROPERLYMOVING AN OBJECT TO A NEW LOCATION The process of moving (lifting, pivoting, squatting, and carrying) a heavy object. (The same rules would apply to moving a patient.) The object will be moved from a waist high area to a lower area five to ten feet away. The procedure will combine all the rules of body mechanics previously discussed.
  35. 35. STEPS INVOLVED IN PROPERLYMOVING AN OBJECT TO A NEW LOCATION  Identify the object to be moved.  Adopt a stable base of support.  Your feet are separated.  One foot is behind the other.  Your back is straight.  Grasp the object at its approximate center of gravity. Pull the object toward your body's center of gravity using your arm and leg muscles
  36. 36. STEPS INVOLVED IN PROPERLYMOVING AN OBJECT TO A NEW LOCATION  Re-establish your base of support and appropriate body alignment.  Your back is straight. You have a stable base of support.  You are holding the object approximately at waist height and close to your body.  Pivot toward the desired direction of travel. Turn on both feet at the same time. Maintain a stable balance.
  37. 37. STEPS INVOLVED IN PROPERLYMOVING AN OBJECT TO A NEW LOCATION  Re-establish a stable base of support and appropriate body alignment. Your back is straight. Your feet are apart, one slightly behind the other. The object is at hip level, close to your body Squat and place the object onto the lower area.  Bend at the knees and hips.  Maintain a straight back. Maintain a stable base of support. Use your arm and leg muscles (as needed) for guidance.  Use your leg muscles to resume an upright position
  38. 38. Second session
  39. 39. Positioning Clients
  40. 40. Positions and Uses  Dorsal (supine): * Place patient on back with head and shoulders are slightly elevated. * Used for physical assessment , to provide comfort , & change position.
  41. 41. Positions and Uses  Dorsal recumbent: * Place patient on back, legs flexed and slightly rotated outward *Used for pelvic examination, female catheterization, perinal care
  42. 42. Positions and Uses  Semi-fowler’s position: * Sitting position with or without positioning pillow at head 45-60 degree. used for eating and facilitate breathing.
  43. 43. Positions and Uses  High fowler’s position: *Head & trunk are raised 60-90 degrees, used for some people with heart problems or having difficulty breathing.
  44. 44. Positions and Uses Prone position: * Lying flat on the abdomen, arm flexed toward head, & head turned to one side. Useful for some unconscious patients. spinal cord problems
  45. 45. Side-lying Position  Major weight on dependant hip and shoulder.  Use supportive foam blocks or pillows for support
  46. 46. Sims Position  Weight supported by anterior aspects of humerus, clavicle and ileum.  These pressure points are different from other positions, i.e. supine, thereby preserving skin integrity.
  47. 47. Positioning and Ambulating the Adult Patient  One of the basic procedures that nursing personnel perform most frequently is that of changing the patient's position. Any position, even the most comfortable one, will become unbearable after a period of time. Whereas the healthy person has the ability to move at will, the sick person's movements may be limited by disease, injury, or helplessness. It is often the responsibility of the practical nurse to position the patient and change his position frequently. Once the patient is able to ambulate, certain precautions must be taken to ensure the patient's safety.
  48. 48. REASONS FOR CHANGING THE POSITION OF A PATIENT The following are reasons for changing a patient's position.  To promote comfort and relaxation.  To restore body function.  Changing positions improves gastrointestinal function.  It also improves respiratory function.  Changing positions allows for greater lung expansion. It relieves pressure on the diaphragm.
  49. 49. REASONS FOR CHANGING THE POSITION OF A PATIENT  To prevent deformities. When one lies in bed for long periods of time, muscles become atonic and atrophy.  Prevention of deformities will allow the patient to ambulate when his activity level is advanced.  To relieve pressure and prevent strain (which lead to the formation of decubiti).  To stimulate circulation. To give treatments (that is), range of motion exercises).
  50. 50. BASIC PRINCIPLES IN POSITIONING OF PATIENTS  Maintain good patient body alignment. .  Maintain the patient's safety.  Reassure the patient to promote comfort and cooperation.  Properly handle the patient's body to prevent pain or injury.
  51. 51. BASIC PRINCIPLES IN POSITIONING OF PATIENTS  Keep in mind proper body mechanics for the practical nurse. Obtain assistance, if needed, to move heavy or helpless patients. Follow specific physician's orders. A physician's order, such as one of the following, is needed for the patient to be out of bed. "Up ad lib." "Up as desired." "OOB" (out of bed).  Do not use special devices (that is., splints, traction) unless ordered. Ask if you do not know what is allowed.
  52. 52. TURNING THE ADULT PATIENT General Principles for Turning the Adult Patient .  Sometimes the physician will specify how often to turn a patient.  A schedule can be set up for turning the adult patient throughout his "awake" hours.  The patient should be rotated through four positions (unless a particular position is contraindicated):
  53. 53. Turning a Patient  Determine what patient can do, find assistance if it is needed.  Position height of bed for nurses’ comfort.  Position patient supine on far side of bed.  Patient arms across chest, far leg over near one.  Tighten girdles, flex knees.
  54. 54. Positioning/Moving a Client Up in Bed  Allow patient to move himself if he can.  HOB down---don’t move up hill.  Position height of bed for nurses’ comfort.  Have patient flex knees, chin to chest, arms folded across chest  Nurses tightens abdominal girdles, flex knees.  Nurses shift weight, moving patient.  Reposition HOB, bed in low position.
  55. 55. Use Mechanical Devises  Lifts will save backs, yours included.
  56. 56. 1.PILLOWS:  Used for support to maintain correct body alignment Used under head, arms, legs & along spine or abdomen  Correct positioning reduces strain on muscles & joints COMFORT DEVICES
  57. 57. COMFORT DEVICES  Support pts back at an angle, so that he may maintain a sitting position Can be adjusted to desired angle  Extra pillows are needed Arms of pt are well supported Used for pts suffering with cardiac & pulmonary distress PURPOSES To relieve Dyspnea To promote drainage from abdominal cavity To provide a comfortable change of position.  2.BACK REST
  58. 58. Comfort device contd……  3.BED CRADLE Is a frame used to hold the bed linen from touching the pt •Used to prevent pressure from the weight of linen •Used to allow air to circulate around lower limbs •Cradle is often a semicircular frame of metal May be made of wood or bamboo It may be made into a rectangular shape.
  59. 59. Comfort device contd…… 4.CARDIAC TABLE /ORTHOPNEIC/BED TABLE:  Usually for pts who are propped up in a sitting position for change of position Bed table placed in front with a pillow on it, pt can lean forward & take rest  Table without pillow is used for writing & meals  Used for pts with cardiac conditions & asthma Makes it possible to use accessory muscles of respiration  Position sh0ud be changed to relieve fatigue & prevent embolism .
  60. 60. Comfort device contd…… 5.MATTRESSES 2 types One that fits on bed frame. Ex: standard bed mattress Mattresses that fit on standard bed mattress. Ex: egg crate mattress
  61. 61. 6.BED BOARDS Boards are usually made of wood & are placed under the mattress to provide support
  62. 62. 7.CHAIR BEDS Beds can be placed into the position of chair for pts who cannot move from the bed but require a sitting position
  63. 63. Comfort device contd…… 8.TRAPEZE BAR Bar is suspended from an overhead frame that extends from the foot to head of bed Pt can grasp the bar to raise the trunk off the bed surface or to move up in bed
  64. 64. 9.FOOTBOARD Device that is placed towards the foot of pts bed to serve as support for his feet Some fit onto the sides of bed frame & rest on the mattress at any point along the bed Usually made up of wood/plastic/heavy canvas
  65. 65. Comfort device contd…… 10.FRACTURE BOARD:  Is a support that is placed under pts mattress to give added rigidity to the mattress Usually made of wood/canvas & is constructed to fit the standard hospital bed
  66. 66. 11.BALKAN FRAME : Frame made of wood or metal that extends lengthwise above the bed & is supported at either ends by a pole Trapeze may be attached to the frame just above pt’s head as an aid to the pt in lifting himself up in bed
  67. 67. Comfort device contd…… 12.BRADFORD FRAME: Is a canvas stretcher like device that is supported by blocks on the foundation of bed Used to immobilize pts who have injured spines. canvas is divided into 3 parts so that small center portion can be removed to insert a bedpan
  68. 68. Comfort device contd……
  69. 69. 13.TROCHANTER ROLLS  Prevent external rotation of legs when pt is in supine position A cotton bath blanket/sheet is folded lengthwise to width extending from greater trochanter of femur to lower border of popliteal space Blanket is placed under the buttocks & rolled away from the pt until thigh is in neutral position with patella
  70. 70. TROCHANTER ROLLS
  71. 71. Comfort device contd……  Provide support & shape to body contours Immobilize extremities & maintain specific body alignment  They are filled plastic bags that can be shaped to body contours Can be used in place of, or in addition to trochanter rolls 14.SANDBAGS:
  72. 72. Comfort device contd 15.HAND ROLLS  Maintain thumb in slightly adducted & in opposition to fingers  Maintain fingers in slightly flexed position  Can be made by folding a washcloth in half, rolling in lengthwise & securing roll with tape.  Roll is placed against palmar surface of hand
  73. 73. Comfort device contd……  16.HAND-WRIST SPLINTS Individually molded for the patient to maintain proper alignment of the thumb in slight adduction & wrist in slight dorsiflexion These splints should be used for the patient whom the splint was made.
  74. 74. 17.SIDE RAILS • Are bars positioned along the sides of the length of the bed •Ensure pt’s safety & are useful for increasing mobility • Provide assistance in rolling from side to side or sitting up in bed
  75. 75. Comfort device contd….. 18.WEDGE/ABDUCTOR PILLOW  Is a triangular shaped pillow made of heavy foam  Used to maintain legs in abduction following total hip replacement surgery
  76. 76. WEDGE/ABDUCTOR PILLOW
  77. 77. Nursing Diagnoses  Activity Intolerance  Impaired Physical Mobility  Risk of Disuse Syndrome  Self-Care Deficits  Altered Health Maintenance  Risks for Falls
  78. 78. Planning and Outcome Identification  Bed Rest  Restorative Nursing Care (Changing position)  Health Promotion and Fitness
  79. 79. Assisting with Ambulation  Assistive Devices -Canes -Crutches -Walkers

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