Patients position

1. POSITIONS
A.Deeparani.,RNRM
D.N.S
Prashanth Hospitals,Velacherry,Chennai-42

2. DEFINITION
Positioning is defined as planning the person in a
proper body alignment for
preventive, promotive, curative
the purpose of
and rehabilitative
aspects of health or placing the patient in good body
alignment asneeded therapeutically.

3. PURPOSES
To promote comfort to thepatient
To relieve pressure on variousparts
To stimulate circulation
To provide proper bodyalignment
To carry out nursingintervention
To perform surgical and medicalinterventions
To prevent complications causedby immobility
To promote normal physiologicalfunctions

4. PRINCIPLES
1. Maintain good bodymechanics
2. Wash hands before and after procedure
3. Ensure patient’s comfort
4. Obtain assistance asrequired
5. Ensure that mattress is firm and level of bed is a
t
working hide
6. Follow safety measures to preventaccidents
7. Follow the systematic and orderly way ofdoing
8. Use right technique at righttime

5. 1. SUPINE POSITION
The patient lies on his back with his head and
shoulders are slightly elevated
Indication
Usual position
Examination of the chest andabdomen

7. PROCEDURE
Place the patient on back with one pillow under the
head, arms and hands at the sides, knees flexed
and separated.
Place the air ring under the hips and cotton or foam
pads under the heels to reduce thepressure.
Place footboard under bottom offeet.
If the patient is aparalyzed, place hand role i
nhand.
Align the patient’s body in goodposition.

8. AIR BAGS FOOT BOARD

9. 2. PRONE POSITION
Position in which the patient lies on the abdomen
with the head turned to one side with one small
pillow under the ankle.
Indications
Post operatively
burns, injuries and
Patient with pressure sores,
operations on the back.
To relieve abdomendistension

11. CONTD..
Indications..
Renal biopsy.
Examine the back
For patients after 24 hours of amputation of lower
limbs

12. PROCEDURE
Explain the procedure
Provide privacy
Place the patient flat on abdomen with one pillow
under the head
Turn patients head to one side and align the patient
in goodposition
Place both arms at the side of the head and support
arm in flexed position at level of shoulder.
Support lower legs with pillows toelevate toes.

13. 3. LATERAL POSITION
The client lies on the side with weight on hip and
shoulder or the patient lies on his side with both
arms forward and his knees and hips flexed.
The upper leg is flexed more than the lowerleg.
The upper knee and hip should be at the same
level.
A pillow is given under the head, back and front t
o
support the arms andabdomen.
Asmall pillow is given in between the knees.

15. INDICATIONS
Patients who requires periodic position
changes
In immediate post-operativepatients
Used for examination ofperineum
Inserting suppositories.
For taking rectaltemperature.
Giving backcare
For giving enema and colonic irrigation.

16. PROCEDURE
Explain the procedure
Provide privacy
Lower the head of bed aslow aspatient cantolerate.
Position the patient to side ofbed
Turn the patient toone side

17. CONTD..
Place the air ring under the hips to reduce pressure i
n
trochanters and at the hipjoints.
Position both arms in flexed position. Upper most a
r
m
s
are supported by pillow on level with shoulder.
Place pillow under back
Place pillow under semi flexed upper leg at hip, from
groin to foot.
Place sand bag parallel to plantar surface of
dependent foot.

18. 4. LITHOTOMY POSITION
The client lies supine with hips flexed. Thelegs are
separated and thighs are flexed.
The patient’s buttocks are kept at the edge of t
h
e
table and legs are supported by stirrups.

20. INDICATIONS
For delivery ofbaby
For rectal examination &surgeries
For vaginal examination & hysterectomy

21. PROCEDURE
Explain the procedure to thepatient
Provide privacy
Position the patient to lie on his back withone pillow
under the head
Keep the legs well separated and the thighs well
flexed on the abdomen and the legs on thethighs
Buttocks are kept on the edge of the table and the
legs are supported on stirrups

22. 5. DORSAL RECUMBENT POSITION
Patient lies on back, knees fully flexed, thighs
flexed and externally rotated feet flat on the bed.
In this position clients with painful disorders are
more comfortable with kneesflexed.
This position should not be used for abdominal
assessment because it promotes contraction of
abdomen muscles.

24. INDICATIONS
douche,
It is used for catheterization,
vaginal vulval, vaginal and rectal
examination
It is also used for vaginal operations and insertion
of tampons

25. PROCEDURE
Place the patient on back in bed with two or more
pillows under the head for patient’scomfort.
Place the air ring under the hips and cotton rings o
r
foam pads under the heels to reducepressure.

26. 6. FOWLER’S POSITION
It is a sitting position in which the head is elevated
at 45˚ to 60˚, and the client knees are slightly
elevated, avoiding pressure on the popliteal
vessels.
Backrest and two pillows are used for the back and
head. Pillows can be used to maintain natural
alignment of the hands wrist andforearms.

31. INDICATIONS
To relieve dyspnea
To improve circulation
T
o relax the muscles of the abdomen, back
and thighs.
To relieve tension on abdominalstature.

32. PROCEDURE
Explain the procedure
Elevate the head of thebed
Rest the head against mattress or smallpillow.
Use pillow to supportarm.
Place asmall pillow at lowerback.
Place foot board at bottom of patient’s feet.
Place the patient in sitting position with arms at sites
a
nd knees raised with pillow.

33. 7. SIMS POSITION
In this position the client lies on either the right o
r
left side.
The lower arm behind the body and upper arm i
s
bent at the shoulder andelbow.
The knees are both bent, with the upper most leg
more acutely bent.
These positions similar to the lateral position except
that the patient’s weight is on the anterior aspect of
the patient’s shoulder girdle and hip.

35. INDICATIONS
Vaginal and rectal examination
Administration of enema andsuppository
Used for relaxation in antenatalexercises
Position for sigmoidoscopy and protoscopy

36. SIGMOIDOSCOPY
PROTOSCOPY

37. PROCEDURE
Explain the procedure to thepatient
Provide privacy
Place the patient on theside
Place small pillow under head andneck
Place pillow under flexed upper arm, supporting arm
level with shoulder.
Place pillow under flexed upper leg, supporting leg level
with hip.
Place sand bagsparallel to plantar surface of dependent
foot.

38. 8. TREDLENBERG POSITION
In this the patient lies on the back with the h
e
a
d
low.
The foot of the bed is elevated at 45˚angle. Entire
frame of bed is tilted with head of bed down.

40. INDICATION
Used in emergency situations like shock,
hemorrhage and hypotension
Postural drainage
Patients with deep vein
thrombosis

41. PROCEDURE
Explain the procedure to patient
Place the patient in supine position
Lower the head end of the bed or if it is n
o
t
adjustable type, use bed block at foot end and tilt
entire frame of bed down. OR elevate the foot
end at 45˚angle.
The patient is carefully supported to prevent
from slipping.

42. 9. KNEE CHEST POSITION
The patient rests on the knees and thechest.
The body is at 90˚ angle to the hips with back
straight, the arm above the head, and the head
turned to one side.
The abdomen remains unsupported.

44. USES
Used for vaginal and rectal examination
Used in first aid treatment in cord prolapse or
retroverted uterus
As exercise for postpartum and gynecology
patients.

45. PROCEDURE
Explain the procedure to the patient
Make the patient rest on the knees andchest
The head is turned to one side with the cheek o
na
pillow.
The arm should be extended on the bed a
n
d flexed
at the elbows to support the patient partially.

46. 10. ORTHOPNEIC POSITION
• High fowler’s position with over bed table to b
e
placed across the front of the patient.
• Patient to rest both hands on over bed table/on
pillow placed in it and leans forward.
• Leaning forward facilitates respiration b
y allowing
maximum chest expansion by reducing pressure
of abdominal organs on diaphragm.

48. INDICATIONS
•Patients with severe dyspnea
•Cardiac patients
•Position for thoracocentesis
•Patient with chest drainage tubes