Nursing assistant III Unit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and Residents
POSITIONING PATIENTS AND RESIDENTS Changing positions frequently helps us stay comfortable Complications can arise from spending long periods of time in same position Many reasons why person may not be able to change positions POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Integumentary System Pressure ulcers (decubitus ulcers) (bed sores) Where bony areas press against mattress Very difficult to heal Develop in 4 stages POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Stage 1 Ulcer POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Stage 2 Ulcer POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Stage 3 Ulcer POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Stage 4 Ulcer POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Musculoskeletal Contractures Stiffness Atrophy Calcium loss POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Respiratory system Prevent lungs from completely filling with air Atelectasis Pneumonia POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Cardiovascular System Venous return Blood clots Stasis ulcers POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Cardiovascular System POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Cardiovascular System POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Serious Complications Cardiovascular System POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Proper positioning is necessary for proper body alignment Spine should not be twisted or crooked Most comfortable Relives strain on muscles and spine Helps prevent pressure ulcers POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Supine (Dorsal Recumbent) Position Lying on the back Bed is flat Head supported by a pillow Subject to pressure ulcers on the heels and sacrum Sand beds Heels must be elevated Place pillow under person’s calves POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Fowler’s Position Similar to supine position with the head of the bed elevated to 45 and 60 degrees Semi-Fowlers Head of bed 30-45 degrees High-Fowlers Head of bed between 60-90 degrees Knee-gatch area of bed may be elevated as well Comfortable for reading, watching TV, talking with visitors, etc. Good for management of certain diseases POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Lateral Position Lying on the side Must document which side person is laying on Lower leg is straight Upper leg is bent and supported by a pillow Upper arm is supported by a pillow Often used for people with back pain, or in a body cast Part of the cycle of positions POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Prone Position Lying on the abdomen with the head turned to the side Pillow under the head, lower abdomen, and feet Many people are not comfortable in this position POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Sims’ Position An extreme side laying position that is almost prone Head turned to one side with knee bent sharply on that side Used for receiving enemas, and to relieve pressure on coccyx or greater trochanter POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Sitting Position Feet should rest flat on the floor Knees bent approximately 90 degrees Buttocks and back against backrest Arms should be supported POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Basic Positions Trendelenburg Position Supine with feet above the level of the head Used for patients with low blood pressure Caution with head injuries Increases ICP POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Repositioning a Person Some people require repositioning as frequently at ever hour Most people require repositioning every 2 hours Each time you reposition be observant to complications People who you are moving are at higher risk for shearing and friction injuries POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Repositioning a Person Shearing Caused by pulling a person across a sheet or other surface that offers resistance The skin is dragged, injuring the underlying tissues and muscles Leads to skin breakdown POSITIONING PATIENTS AND RESIDENTS
POSITIONING PATIENTS AND RESIDENTS Repositioning a Person Moving person to side of bed Moving a person up in bed Raising head and shoulders Turning person on side Logrolling Transferring to a stretcher Using a mechanical lift POSITIONING PATIENTS AND RESIDENTS