Positioning A Patient Horizontal Recumbent or Supine Position - PowerPoint Presentation

Slide1

Positioning A PatientSlide2

Horizontal Recumbent or Supine Position

Used for examination or treatment of the front or anterior part of the body

Patient lies flat on back with legs slightly apart

One small pillow is allowed under the head

Arms are flat at side of body

Drape patient with large sheet or drape

Do not tuck in sheet at sides or bottom

Drape is left loose on all sides to facilitate examination or treatmentSlide3

Prone Position

Used for examination of back or spine

Patient lies on abdomen with head turned to either side

Small pillow is placed under the head

Arms are flexed at the elbows and positioned on either side of the head or positioned along side of body

Drape patient with large sheet or drape

Do not tuck in sheet at sides or bottom

Drape is left loose on all sides to facilitate examination or treatmentSlide4

Sims’ or left lateral position

Used for simple rectal or

sigmoidoscopic

examinations, enemas, rectal temperatures, and rectal treatments

Patient lies on left side

Head rests on small pillow and is turned to side

Left

arm

is extended behind the back

Right arm is bent at elbow and placed in comfortable position in front of the body

Left leg is bent or flexed slightly

Cont…..Slide5

Right leg is bent or flexed sharply and brought up to the abdomen

Drape patient with on large sheet or drape

Do not tuck in sheet at sides or bottom

Drape is left loose on all sides to facilitate examination or treatment

Two sheets can also be used to drape patient

One sheet covers upper part of body

Second sheet covers thighs and legs and meets top sheet

Sheet with a hole at examination site may also be usedSlide6

Knee-chest position

Used for rectal examinations – usually a

sigmoidoscopic

exam

Patient lies on abdomen or in prone position

Patient raises buttocks and abdomen until weight is resting on upper chest and knees

Head rests on small pillow and is turned to either side

Arms are flexed slightly at the elbows and positioned by the sides of the head

Knees are separated slightly

Cont….Slide7

Thighs are at right angles to the table/bed

Draping can be done different ways

One large sheet can be used to cover the patient

A large sheet with a hole at the rectal area can be used

Two smaller sheets or drapes that meet at the rectal area can be used

Do not tuck in sheets a sides or bottom

Drape is left loose on all sides to facilitate examination or treatment

Cont….Slide8

Special Safety precautions

Do not place patient in this position until the physician is ready to begin the examination

Remain with patient at all times while patient is in knee-chest position

Difficult position to maintain and should be used only as long as absolutely necessary.

After examination is complete, place patient in prone position and then turn over to supine

Watch closely for signs of dizziness or discomfortSlide9

Fowler’s position

Used to facilitate breathing; relieve distress; encourage drainage; and examine the head, neck and chest

Patient lies on back with head elevated at different angles

Low-Fowler’s: head elevated at 25 degree angle

Mid-Fowler’s or semi-Fowler’s: head elevated at 45 degree angle

High-Fowler’s: head elevated at 90 degree angle

Place small pillow under patient’s head

Cont…Slide10

Keep legs flat on the table but flex knees slightly and place small pillow under knees

Drape with a large sheet or drape

Do not tuck in sheet at sides or bottom

Drape is left loose on all sides to facilitate examination or treatmentSlide11

Lithotomy

Used for vaginal examinations, Pap tests, urinary

catherization

,

cystoscopic

examinations, and surgery of small pelvic area

Patient lies on back with head on small pillow

Arms rest at sides of body

Patient slides buttocks down on table to where lower end of table folds down or pulls out

Place sheet or drape over patient in diamond position

Put one corner at chest, one corner between legs, and each of other two corners at sides

Wrap each side corner around a footSlide12

Cont…

Flex and separate the knees

Place feet in stirrups on table

Drop lower end of the table or push it in if this is possible

To remove patient from position

Raise end of the table or pull it out so it is level

Lift feet out of stirrups and place on table

Ask patient to slide up on table.Slide13

Dorsal recumbent position

Similar to

lithotomy

position and used for same purposes

Patient is on table without stirrups

Feet are separated but flat on the table

Knees are bent at an angle and separated

Draping is in the same diamond pattern used for

lithotomySlide14

Trendelenburg position

Requires a special table or bed and assistance

Care must be taken so patient does not slide off table or bed

Standard

trendelenburg

position

Used for circulatory shock because it increases circulation of the blood to the brain and head

Patient lies flat on back with head on small pillow

Arms are flat at sides

Entire bed or table is elevated at feet

Power table or electric bed raises the feet at an angle so head is lower than feet

Blocks can be placed under the lower frame of a bedSlide15

Surgical trendelenburg

Used for surgery on pelvic organs and pelvic treatments

Patient lies flat on back with head on small pillow

Arms are flat at sides

Top of table is lowered at and angle to lower the head

Bottom of table is lowered at a 45 degree angle to incline legs and feet downward

Straps are frequently used to hold patient in positionSlide16

Draping for Trendelenburg

Usually, one large sheet is used to drape patient

For surgical procedures, use a large sheet with a hole to expose the surgical area

Two smaller sheets or drapes can also be used and positioned to meet at surgical or treatment area

Do not tuck in sheet at sides or bottom

Drape is left loose on all sides to facilitate examination or treatment

Safety precautions: use straps to secure patient in this position, remain with the patient at all timesSlide17

Jackknife (proctologic) position

Used for rectal surgery or examinations or for back surgery and treatments

Requires a special table that will break in the middle

Care must be taken so patient will not slide off or be injured in any way

Patient lies in prone position

Secure safety straps on the table around patient

Lower top of table so the feet and legs are inclined at a downward angle

Cont…Slide18

Draping for jackknife

One large drape or sheet can be used to cover patient

For surgical procedure, use a large sheet with a hole at the surgical site

Two small sheets can also be used and positioned to meet at the surgical or treatment area

Do not tuck in sheet at sides or bottom

Drape is left loose on all sides to facilitate examination or treatment

Special safety precautions:

remain with patient at all times, watch for signs of dizziness, pain, or discomfortSlide19

Basic principle for

positioning patients

Determine the examination, treatment, or procedure to be performed

Determine which position or positions will be required

Prepare the examination table by wiping it with disinfectant and covering it with table paper

Prepare patient correctly: follow agency policy for procedure or treatment

Ask patient to remove all clothes including underwear

Tell patient to put on exam gown

Instruct the patient to leave the opening in the front or back depending on the exam

Ask

patient to void to prevent bladder discomfort during the exam or treatmentSlide20

Assist patient onto table

Position patient in correct position

Drape patient correctly for position

To change positions

Hold up drape while patient turns

Always ask patient to turn toward you

Brace your body against side of table

Be alert so patient does not roll off table

Observe all safety precautions

Watch patient for signs of dizziness, pain, or discomfortSlide21

When examination or treatment is complete, assist patient to a sitting position slowly

Assist patient off table

Clean and replace all equipment

Wash hands

Record all

required information