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POSITIONING.pptx for GNM first year Nursing students

Positioning involves placing a patient in various body alignments to promote health, comfort, and the ability to perform medical procedures. The goals of positioning are to relieve pressure, improve circulation, prevent deformities, and allow for assessments and interventions. Factors such as a patient's needs, abilities, disease, and consciousness level must be considered when determining the appropriate position. Common positions include supine, lateral, prone, and Fowler's position, each used for different medical purposes and procedures. Careful positioning is important for patient comfort and skin integrity.

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POSITIONING • Positioning defined as placing the person in such a way to perform therapeutic interventions to promote the health of an individual. • Positioning defined as placing the person in a proper body alignment for the purpose of preventive, promotive, curative and rehabilitative aspects of health.
Purpose • To provide comfort to the patient • To relieve pressure on various parts • To improve circulation • To prevent formation of deformity • To carry out investigations • To perform surgical and medical investigations • To prevent pressure sores • To provide proper body alignment • To conduct delivery/labor • To carryout nursing interventions.
Principles of Positioning • Need of an individual • Self care ability • Extend of disability • Nature of disease condition • Level of consciousness • Protocol of the hospital.
TYPES OF POSITIONS • Dorsal position • Dorsal recumbent position • Lithotomy position • Lateral position • Prone position • Sim's position • Knee-chest position • Trendelenburg's position • Fowler's position.
Supine position • Supine position the patient lies on his back with his head and shoulders are slightly elevated. One pillow is given under the head. His legs should be slightly flexed. A small pillow is placed under his knees.ex- intracranial,cardiac,abdominal,laproscopicpro cedure
Lateral position • Patient lies on left side with legs flexed at thighs. The upper leg is flexed more than the lower. A pillow is kept in front of the abdomen and at the back and one under the upper leg • Ex-surgical access to thorax,kidney because drainage of any secretion and maintance of airway.
Prone position: • A patient lies flat on abdomen. Head turned to sideways. One soft pillow is given under head. An extra pillow is given under the ankles to keep toes from touching the bed.ex-Spine and neck surgery,neurosurgery.it ll increases functional capacity and deliver more oxygen.
Dorsal recumbent position • Patient lies on back, knees fully flexed, thighs flexed and externally rotated feet flat on the bed.ex-vaginal examination
Semi-fowler's position • The semi-fowler's position is the position of a patient who is lying in bed in a supine position with the head of the bed at approximately 30 to 45 degrees.ex-difficulty in breathing
Fowler's position • Fowler's position is a sitting position in which the head is elevated, at least, a 45 degree angle. Back rest and two pillows are used for the back and head. Fowler's position the main weight bearing areas of the patient are the heels, sacrum(at the base of lumbar vertebae) and the posterior aspects of the ileum(last part of SI).ex-defecating,eating,swallowing
Lithotomy position: • The patient lies on her back. The legs are separated and thighs are flexed.. The patient's buttocks are kept the edge of the table and legs are supported by stirrups.
Assisting the patient in knee-chest position • A prone position in which the individual rests on the knees and upper part of the chest, assumed for gynecologic or rectal examination.
Knee-chest position: • Patient rests on the knees and the chest. The head is turned to one side with one check on a pillow. A pillow is placed under the chest. The weight is on the chest and knees.ex- spinesurgery
Cardiac position: • The client is propped-up in a sitting position by means of back rest and pillows. Place an over bed table in front with a pillow on it. The client has an aircushion to sit and a small pillow under the knees
Trendelenburg's position • The patient lies on his back. The patient's head is low. The foot of the bed is elevated at 45 degree angle. The body is on an inclined place and the legs hang downward over the end of the table.ex-Lower abdominal surgery including colorectal,gynecological,GI procedures
Types of Patients Need Special Care • Unconscious patient • Infant and children • Hemiplegic and paraplegic patients • Immediate postoperative patients • Orthopedic patients • Cardiac patients.
General Instructions • Maintain good body alignment of the patient at all times • Support body parts in good alignment by using supportive devices to promote comfort and prevent undue muscle strain • Avoid prolonged flexion of any one body segment by changing the position at least every two hours • Reduce the pressure caused by body weight of his or her body or object by changing the position and using protective devices.
Preliminary Assessment • Check the patient's general condition• • Check the physician's order for any limited movement. • Assess the self-care ability of an individual • Arrange the comfort devices near the bedside • Identify the deformed extremity • Support the immobilize area during positioning • Identify the rationale before positioning.
Equipment • Extra man power if needed • Extra pillowsSheets and sheet rolls • Comfort devices such as back rest, cardiac table etc.
Procedure • Explain the procedure to the patient • Provide privacy• • Arrange the articles and manpower (if needed) • Untie the bed sheets• • Turn/lift/ambulate • gentlyPlace and support with extra pillows under pressure points • Special care taken at pressure areas • Cover the patient with top sheet • Hand wash • Record the time, position and condition of the skin.