Positioning the client

Promotion of client comfort and safety and ensuring proper alignment

• Make sure the mattress is firm and level yet has enough give to fill and support natural
boy curvatures.
• Ensure the bed is clean and dry
• Place support devices in specified areas according to the client’s position
• Avoid placing one body part, particularly one with bony prominences directly on top of
another body part
• Plan a 24 hour schedule for position changes

• DORSAL/SUPINE POSITION
 Used for most physical examinations
 Head and shoulders are not elevated
 Patient is on his back with legs extended.
 Arms may be above the head, alongside the body or folded on the chest.
SUPINE POSITION
• Facilitate healing following certain surgeries/anesthetics
Dorsal Recumbent Position
 Patient is on his back with knees flexed and soles of feet flat on the bed.
 Head and shoulders are slightly elevated on a pillow
 Fold sheet once across the chest.
 Fold a second sheet crosswise over the thighs and legs so that genital area is easily
expose
 Used to provide comfort
 Used for perineal care

PRONE
 Used to examine spine and back.
 Patient lies on abdomen with head turned to one side for comfort.
 Arms may be above head or alongside body. Cover with sheet or bath blanket.
 Both adult and children sleep in this position
 Only bed position that allows full extension of the hip and knee joints
 Helps prevent flexion contractures
 Promotes drainage from the mouth
 Useful for unconscious client or those recovering from surgery of the mouth or throat

DISADVANTAGES OF PRONE POSITION

• Produces marked lordosis
• Neck is rotated laterally to a significant degree
• Causes plantar flexion
• Confining and suffocating
• Note: should be used only when the client’s back is correctly aligned and only for short
period of time
LATERAL/SIDE LYING
 Used for rectal examination.
 Patient is on left side with right knee flexed against abdomen and left knee slightly
flexed.
 Left arm is behind body; right arm is placed comfortably.
NOTE: Patient with leg injuries or arthritis usually cannot assume this position.
 Reduces lordosis
 Promotes good back alignment
 Good for resting and sleeping clients
 Helps to relieve pressure on the sacrum
 Comfortable for client with unilateral sensory/motor deficits

SIMS’ POSITION
 Also called semi prone
 Client assumes a posture halfway between the lateral and prone position
 Lower arm is positioned behind the client and the upper arm is flexed at the shoulder
and the elbow
 Both legs are flexed in front of the client

INDICATIONS FOR SIMS’ POSITION

 Unconscious client
 Paralyzed client
 For client receiving enemas
 Examination/treatment of the perineal area
 Comfortable for pregnant position for sleeping

KNEE CHEST
 Used for rectal and vaginal examinations and as treatment to bring uterus into normal
position.
 Patient is on knees with chest resting on bed and elbows resting on bed or arms above
head.
 Head is turned to one side. Thighs are straight and lower legs are flat on bed.
NOTE: Do not leave patient alone; he/she may become dizzy, faint, and fall.

TRENDELENBURG
 Position of choice for client with hypotension or in shock

LITHOTOMY
 FOR MAXIMAL GENITALIA EXPOSURE
 MAYBE EMBARASSING AND UNCOMFORTABLE FOR CLIENT
NOTE: CONTRAINDICATED IN CLIENTS WITH JOINT DISORDERS
FOWLERS
• Used to promote drainage or ease breathing. Head rest is adjusted to desired height and
bed is raised slightly under patient's knees

SEMI FOWLER’S POSITION

Head and trunk raised to 15-45 degrees

HIGH FOWLER’S POSITION

head and trunk are raised 90 degrees

ORTHOPNEIC
• Client sits either in bed or on the side of the bed with an over bed table across the lap
• Facilitates respiration by allowing maximum chest expansion esp for client with
problems exhaling

ASSISTIVE/SUPPORT DEVICES
MATTRESSES
PILLOWS - FOR SUPPORT OR ELEVATION OF BODY PARTS
BED BOARDS - made of wood and placed under the mattress
FOOT BOARD - A flat panel often made of plastic or wood
• Keeps feet in dorsiflexion to prevent plantar flexion
FOOT BOOT - Have a firm exterior and padding of foam to protect the skin
• Provide support to keep feet in natural position

CHAIR BEDS - Beds can be placed into the position of a chair for client who cannot move from bed but
require sitting position

TROCHANTER ROLL OVER BED TABLE WALKER

TRANFER BELT WHEELCHAIR

OVER BED TABLE WHEELCHAIR