NURSING ASSISTANT III Unit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and...

NURSING ASSISTANT IIIUnit 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


Serious Complications Integumentary System

Pressure ulcers (decubitus ulcers) (bed sores)

Where bony areas press against mattress

Very difficult to heal

Develop in 4 stages


Serious Complications

Stage 1 Ulcer



Stage 2 Ulcer



Stage 3 Ulcer



Stage 4 Ulcer


Serious Complications Musculoskeletal

Contractures

Stiffness

Atrophy

Calcium loss


Serious Complications Respiratory system

Prevent lungs from completely filling with air

Atelectasis

Pneumonia


Serious Complications Cardiovascular System

Venous return Blood clots

Stasis ulcers


Serious Complications Cardiovascular System


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


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


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


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


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


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


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


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


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


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


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

NURSING ASSISTANT III Unit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and...

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