Positioning

1. 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.

2. 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.

3. Principles of Positioning
• Need of an individual
• Self care ability
• Extend of disability
• Nature of disease condition
• Level of consciousness
• Protocol of the hospital.

4. 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.

5. 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

7. 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.

9. 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.

11. Dorsal recumbent position
• Patient lies on back, knees fully flexed, thighs
flexed and externally rotated feet flat on the
bed.ex-vaginal examination

13. 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

15. 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

17. 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.

19. 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.

20. 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

22. 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

24. 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

26. Types of Patients Need Special Care
• Unconscious patient
• Infant and children
• Hemiplegic and paraplegic patients
• Immediate postoperative patients
• Orthopedic patients
• Cardiac patients.

27. 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.

28. 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.

29. Equipment
• Extra man power if needed
• Extra pillowsSheets and sheet rolls
• Comfort devices such as back rest, cardiac
table etc.

30. 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.