Positioning involves placing a patient in various body alignments to promote comfort, relieve pressure, improve circulation and lung function, and enable medical procedures and examinations. Some key positions include supine, prone, lateral, lithotomy, Fowler's, Sims, Trendelenburg, knee-chest, and erect. Positioning follows principles like maintaining good body mechanics, ensuring patient comfort and safety, and preventing complications like pressure injuries.

1. POSITIONS
Ms Shiwani Sah
Lecturer

2. Positioning
Positioning is defined as planning the person in a proper
body alignment for the purpose of preventive, promotive,
curative and rehabilitative aspects of health or placing the
patient in good body alignment as needed therapeutically.
It is one of the basic procedures that nursing personnel
perform most frequently.

6. Purposes
To promote comfort and relaxation to the patient.
To relieve pressure on various parts.
To stimulate circulation.
To provide proper body alignment.
To carryout nursing interventions.
To perform surgical and medical investigations.
To prevent complications caused by immobility.

7. Purposes
 To promote normal physiological functions.
 Changing positions improves gastrointestinal function.
 Changing position allows for greater lung expansion and
improves respiratory function.

8. Principles
Maintain good body mechanics.
Wash hands before and after procedure.
Ensure the patient’s comfort and safety.
Follow the systematic and orderly way of doing.
Use right technique at right time.

9. Principles
Properly handle the patient’s body to prevent pain or injury.
Obtain assistance, if needed, to move heavy or helpless patients.
Ensure that sheets are clean and dry.
Avoid placing a body part directly over another to prevent pressure.
Plan a regular position change schedule for the patient for 24 hours.
Follow specific physician’s orders.

10. Types of Positions Used
Supine/Dorsal/Back Laying
• The patients lies on his back with his head and shoulders are
slightly elevated.
• Pillows may be used under the head, knees for comfort.
• A foot support is used to prevent foot drop and maintain
proper alignment.
• The risk of aspiration is greater with his position thus the
supine position should be avoided when the client is
confused, agitated, experiencing a decreased level of
Consciousness or at risk for aspiration.

11. Indications
The usual position used by the patient.
Used for examination of the chest and abdomen.

12. Problems to be prevented
Hyperextension of neck
Posterior flexion of lumber curvature
External rotation of legs
Hyper extension of knees
Planter flexion
Pressure on heels

13. Prone Position
The prone position is a position in which the patient lies on the
abdomen with the head turned to one side with one small
pillow under the ankle. One soft pillow is given under the
head.

14. Indications
It can be used post operatively to prevent aspiration of saliva and
mucous.
Used in post-operative cases tonsils, vasico vaginal fistula and spinal
cases.
For patient with pressure sores, burns, injuries and operations on the
back.
For patients after 24 hours of amputation of lower limbs.
To relieve abdomen distention.
Position for renal biopsy.
To examine the back.

15. Problems to be prevented
Flexion/hyperextension of neck.
Hyperextension of lumber curvature.
Pressure on breasts, heels and genitals.
Foot drop.

16. Lateral/side laying 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 lower leg.
• The upper knee and hip should be at the same level.
• A pillow is given under the head, back and front to support
the arms and abdomen.
• A small pillow is given in between the knees.

17. Indications
Patient who requires periodic position changes.
In Immediate post-operative patients to prevent the risk of
aspiration.
Used for examination of perineum or rectal inserting
suppositories.
For taking rectal temperature.
Giving back care.
Used for giving enema and colonic irrigation.

18. Problems to be Prevented
Lateral flexion and fatigue of sternocleidomastoid muscle.
Internal rotation and adduction of shoulder and limited chest
expansion
Internal rotation and adduction of femur and twisting of
spine.

19. Lithotomy position
• The client lies supine with hips flexed.
• The legs are separates and thighs are flexed on the abdomen
and legs are flexed on the abdomen and legs are on the
thighs.
• The patient’s buttocks are kept at the edge of the table and
legs are supported by stirrups.

20. Indications
• For delivery of baby.
• For rectal examination and surgeries e.g. hemorrhoidectomy
• For vaginal examination and hysterectomy.

21. Dorsal Recumbent Position
• Dorsal means ‘back’ and recumbent means ‘lying down.’
• So the dorsal recumbent position literally means lying down
on back.
• The client is positioned with the legs spread apart and knees
bent with feet flat on the table.
• In this position clients with painful disorders are more
comfortable with knee flexed.
• This position should not be used for abdominal assessment
because it promotes contraction of abdomen muscles.

22. Indication
• It is used for catheterization, vaginal douche, vulval, vaginal
and rectal examination.
• It is also used for vaginal operations and insertion of
tampons.

23. Fowler’s Position
• It is a sitting position in which the head is elevated at 45 to
60 degrees, 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 and forearms.
• Variations of fowler’s position include high fowler’s and low
fowler’s or semi fowler’s position.

24. High fowler’s position
• This is sitting position position, raised the client’s head 80-90
degrees. Pillow can be used under the head and arms and a
footboard may be used.
SEMI FOWLER’S POSITION
• In this position the client’s head is elevated only at 30-45
degree.

25. Indications
• To relieve disponea.
• To improve circulation
• To relax the muscles of the abdomen, back and thighs.
• To relieve tension on abdomen suture.

26. Sims position (semi prone position)
• In this position the client lies on either the right or left side.
• The lower arm behind the body and upper arm is bent at the
shoulder and elbow.
• 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 anterior aspect of the
patient’s shoulder girdle and hip.

27. Indications
• Vaginal and rectal examination.
• Administration of enema and suppository.
• Used for relaxation in antenatal exercise.
• Position for sigmoidoscopy and proctoscopy.

28. Trendelenburg Position
• In this, the patient lies on his back. The patient’s head is low.
• The foot of the bed is elevated at 45 degree angle.
• Entire frame of bed is tilted with head of bed down.

29. Indications
• Used in emergency situations like: shock, hemorrhage and
hypertension.
• Postural drainage.
• Patients with deep vein thrombosis.

30. Knee Chest Position
• In this, the patient rests of the knees and the chest.
• The weight is on the chest and knees.
• The body is at 90 degree angle to the hips with back straight,
the arm above the head, and the head turned to one side.
• The abdomen remains unsupported.

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

32. Erect position
• This is the normal standing position.