 Discuss what body mechanics is

 Explain the principles of body mechanics

 Describe how to safely position clients
 Body mechanics is the coordinated effort of the
musculo- skeletal and nervous system to
maintain balance, posture and body alignment
during lifting, moving, positioning and
performing activities of daily living.
 Proper posture means that there is a balance
and body parts are in good alignment
( position )
 Good posture allows the body to function at
its best in all activities.
 Correct posture makes lifting, pulling, and
pushing easier
 reduces risk of injury to the musculo-skeletal
system.
 facilitates body movement without muscle
strain and excessive use of muscle energy.
 maintains adequate muscle tone
 prevents fatigue and deformities
 promotes physiological functions of the body
 reduces energy expenditure.
 facilitates aesthetic well-being in terms of
physical fitness and shape.
 Body Alignment refers to the positioning of joints,
tendons, ligaments and muscles while in standing,
sitting and lying positions.
 Body balance refers to a state of the body achieved
when the center of gravity is balanced over a wide,
stable base of support and a vertical line falls from the
center of gravity through the base of support.
 Posture refers to the position of the body in relation to
the surrounding space. It is the relationship of various
body parts at rest or any phase of activity.
 Mobility is a person’s ability to move about freely owing to
his/her voluntary motor and sensory control of the body’s
regions.
 Immobility occurs when the individual is confined to a position
and is unable to move or change positions independently.
 Bed rest is an intervention in which the client is restricted to bed
for therapeutic reasons
 Weight is the force exerted on a body by gravity.
 Friction is a force that occurs in a direction to oppose
movement.
 Anatomical position refers to a position wherein the individual
stands erect (upright position) facing the observer, with feet on
the floor and arms placed at the sides, and the palms of the
hands turned forward.
 Alignment
 Base of support
 Center of gravity
 Fulcrum and lever
 Guidelines for using
proper body
mechanics
1. Keep your back straight

2. Stay Balanced…
Keep your feet separated ( 12 INCHES )
to provide a good base of support.
(see figure ➔)
1. Keep your back straight

2. Stay Balanced…
Keep your feet separated ( 12 INCHES )
to provide a good base of support.
(see figure ➔)
BODY ALIGNMENT

 THE TRUNK OF THE PERSON SHOULD BE IN

A STRAIGHT LINE WHEN THE PATIENT IS
LYING DOWN
 When the body is held
in proper alignment,
the back is in a
"neutral” position,
with the curve of the
lower spine intact.
3. Bend from the hips and knees to get close
to the object. Do not bend from the waist.
(see figure ➔)
4. Avoid lifting whenever possible. Often you can
push, pull roll an object

5. Use the strongest muscles to do the job.

6. Avoid twisting your body as you work and bend for

long periods of time. Try not to twist your body at the
waist. Pivot the whole body.
7. Hold heavy objects close to your body. When
lifting a patient, lean into the patient body,
8. Lift smoothly.

9. Always ask for help if

you feel the
patient or object is too
heavy
to move by yourself.
(see figure ➔)
10. Plan and think through your move.
Before you begin the action, make
sure you are applying proper body
mechanics. Coordinate your movements
by telling patients or other health
workers when you are ready to move.
count “ 1, 2, 3 ….. Lift “
Lifting of Patients
▪ Nurses for their own safety should always
remember the key factor in lifting.
Head Erect
Chin tucked in
to help keep
Back straight

Back Straight
to protect joints
& ligaments
Handgrips
partners forearm firmly
Elbows Close
to sides to use
Muscle force Knees Bent
Efficiently
tocontrol thigh and
Feet Apart buttock
to give a stable
muscle
base
 The finger grip

The wrist grip

The double wrist grip

The through arm grip
At the end of the discussion, the learners will be
able to:
 Identify different positions applicable to
client’s condition
 Demonstrate proper body mechanics when
positioning, moving, lifting, and ambulating
clients
 Encouraging clients to move in bed, get out of
bed, or walk serves several positive purposes.

 By assisting clients to maintain or regain

mobility, you promote self-care practices and
help to prevent complications.
 EVERY BODY SYSTEM IS
AFFECTED
 CONTRACTURE
▪ AN ABNORMAL
SHORTENING OF THE
MUSCLE DUE TO LACK
OF USE
▪ THE MUSCLE IS FIXED
INTO POSITION, IS
DEFORMED, AND
CANNOT STRETCH.
NURSES ARE LEGALLY AND MORALLY
ACCOUNTABLE FOR DECREASING THE
EFFECTS OF IMMOBILITY
HYPERTROPHY—INCREASES IN SIZE WHEN
USED

ATROPHY—DECREASES
IN SIZE WITH NON-USE
 ATROPHY
ATROPHY – A DECREASE IN
SIZE OR A WASTING AWAY OF
MUSCLE TISSUE.
CAUSED BY LACK OF USE
 Osteoporosis=loss of bone mass

Pt’s need an increase in Ca and adequate

activity to maintain bone strength
Contractures: stiffness in JOINT caused
by shortened muscle
NEGATIVE NITROGEN BALANCE

ANOREXIA

DECREASED PERISTALSIS
 ORTHOSTATIC HYPOTENSION

 HEART WORKS 30% HARDER

 THROMBUS FORMATION
 DECREASED RESPIRATORY MOVEMENT
 THICK AND STICKY LUNG SECRETIONS
 KIDNEY STONES
▪ INCREASED BLOOD CALCIUM
 INCREASED URINE pH
 UTI—KIDNEY INFECTION
▪ D/T STASIS OF URINE
 DECUBITUS ULCERS
LATIN WORD FOR LYING DOWN, RECLINING
 DECUBITUS ULCER

A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN

BLOODFLOW TO AN AREA IS INTERRUPTED
MORE DECUBITI
• NERVE IMPAIRMENT—
PRESSURE ON NERVE OR
BLOOD SUPPLY

• DECREASED INTELLECTUAL AND

SOCIAL ABILITIES

• DECREASED SPEED OF
PERCEPTIONS AND REACTIONS

• INCREASED PAIN PERCEPTION

 DECREASED SELF CONCEPT
 DECREASED MOTIVATION
 DECREASED DRIVES
 INCREASED EMOTIONAL DISTURBANCES
 To promote comfort and relaxation.
 To restore body function.
▪ Changing positions improves gastrointestinal
function.
▪ It also improves respiratory function.
▪ Changing positions allows for greater lung expansion.
▪ It relieves pressure on the diaphragm.
 To prevent deformities.
▪ When one lies in bed for long periods of time,
muscles become atonic and atrophy.
▪ Prevention of deformities will allow the patient to
ambulate when his activity level is advanced.
 To relieve pressure and prevent strain (which
lead to the formation of decubiti).
 To stimulate circulation.
 To give treatments (that is), range of motion
exercises).
 Maintain good patient body alignment. Think
of the patient in bed as though he were
standing.
 Maintain the patient's safety.
 Reassure the patient to promote comfort and
cooperation.
 Properly handle the patient's body to prevent
pain or injury.
 Keep in mind proper body mechanics for the
practical nurse.
 Obtain assistance, if needed, to move heavy
or helpless patients.
 Follow specific physician's orders.
 Do not use special devices (that is., splints,
traction) unless ordered. Ask if you do not
know what is allowed
 At the end of the discussion, the learner will
be able to:
 Demonstrate proper body mechanics when
positioning, moving, lifting, and ambulating
clients
 Logrolling is a technique used to turn a
patient whose body must at all times be kept
in a straight alignment (like a log).
 This technique is used for the patient who has
a spinal injury.
 Logrolling is used for the patient who must
be turned in one movement, without
twisting.
 Logrolling requires two people, or if the
patient is large, three people.
 A lifting sheet is often used to help move
clients.This may also be called a transfer
sheet, draw sheet, or turning sheet
 Pillows can be used to support the patient's
head, neck, arms, and hands and a footboard
used to support the feet.
 This belt is a sturdy webbed belt with a buckle
that easily secures around the client’s waist.
 It is important to use a transfer belt whenever
assisting an unsteady weak, faint, or
partially paralyzed person to walk.
 Preventing falls is a primary nursing function
for all nurses.
 If a client feels faint, try to assist the person
into a sitting position
 Even if a client is falling, the nurse must avoid
letting the client grab him or her around the
neck
 Dangling refers to allowing the client to sit
on the edge of the bed, with the legs down
and the feet supported on a footstool or on
the floor. This helps the client who has been
in bed to prepare to sit in a chair and
eventually, to walk.
 Care should be taken to ensure that the client
has a good sense of balance before helping
him or her out of bed
 Some clients have difficulty moving
(transferring) from bed to chair or back again
because of weakness or paralysis (inability to
move a part of the body).
 If a client is quite unsteady or heavy, two
nurses are required to transfer the client
safely from bed to chair or wheelchair.
Nursing Alert :
 Always request assistance if you are not sure
whether you can transfer a client alone.
 Use a transfer belt if there is any question of
the client falling.
 Efficient use of one’s body will determine
how effectively and safely the nurse is able to
move clients.
 It is important to provide safety for both the
nurse and the client.
Reasons to change the client’s position:
 promote comfort
 restore body function
 prevent deformities
 relieve pressure
 prevent muscle strain
 stimulate proper respiration and circulation
 provide diversion, and giving nursing treatments
 Lifting techniques using good body
mechanics. Use long, strong muscles of
arms and legs. Hold the object so the line of
gravity falls within the base of support.
Keep the back straight and the load close
to the body. Ask for assistance, if
necessary.
 Maintain functional client body alignment.
(Alignment is similar whether the client is
standing or in bed.)
 • Maintain client safety.
 • Reassure the client, to promote comfort
and cooperation.
 • Properly handle the client’s body, to
prevent pain or injury
 • Follow proper body mechanics, to protect
yourself and the client.
 Obtain assistance, if needed, to move heavy or
immobile clients.
 • Follow specific provider’s orders.
 • Remember that a specific order is needed for a
client to be out of bed.
 • Do not use special devices (eg, splints, traction)
unless ordered and trained to use this equipment.
 • Make sure the client is comfortable and has the
nurse signal cord available after positioning
 The client is encouraged to defecate before most
examinations, particularly a rectal examination.
 • The client is provided with an examination gown and/or
bath towel to cover the chest and perineal area.
 • A bath blanket or sheet is provided for warmth and
privacy. In some cases, a small pillow is provided.
 • The examination procedure is explained to the client.
 • The body is draped appropriately for client privacy and
examiner’s access.
 • Appropriate lighting is provided for the examiner.
 Appropriate lighting is provided for the examiner.
 • Needed equipment and supplies are prepared before the
examination begins.
 • The nurse stays with the client during the examination.
 • Examiner and nurse wash or sanitize their hands before
and after any examination.
 • Gloves are worn in many cases.
 • Other personal protective equipment is worn when
needed.
 A signed release is obtained from the client when needed.
 • The nurse observes, in order to document the procedure
and to maintain client safety and confidentiality. In addition,
the nurse provides comfort to the client and answers
questions.
 • After the examination, the nurse assists in disposing of
equipment and supplies and readying the examination room
for the next examination.
 • The nurse needs to know why the examination is being
done so the client’s questions can be answered and to
anticipate problems that might arise.
 Every major body joint (i.e., neck, shoulder, elbow, wrist,
finger, thumb, hip, knee, ankle, and toe) must move
regularly several times each day to prevent stiffness and
deformities. For healthy and active people, this exercise
occurs normally in everyday life. For the ill or immobilized
person, however, joint movement may be limited or
impaired. To avoid joint abnormalities, the nurse must be
sure that clients exercise all joints—several times daily—
through ROM exercises.
 If a client is unable to move, the nurse helps
by performing passive range-of-motion
(PROM) exercises. In PROM, the nurse or
therapist moves the client’s joints and assists
in assuming various positions.
 Key Concept Do not force joint movement
when doing PROM exercises. If the client
complains of pain, stop and check with your
supervisor
 ASSISTING THE MOBILE AND PARTIALLY
MOBILE CLIENT
 Some clients are allowed out of bed (OOB)
for the entire day; others are up for certain
lengths of time each day, as their conditions
permit.
 Check the provider’s order to determine the client’s
prescribed level of activity.
 • Assist the client to put on a bathrobe and slippers. Provide
a bedpan, if necessary. Offer a blanket to avoid chilling.
 • Being up after an illness or surgery is tiring. Ask the client
to tell you if he or she is becoming tired, faint, or weak.
 • Offer PRN pain relief medication approximately 30
minutes before the client is to get up. (This will increase
client comfort and may increase the length of time he or she
is able to be up.)
 • Make sure the client’s nurse call signal is within reach, if
you leave the client while he or she is sitting up. (A client
protective device may be necessary, to prevent the client
from falling out of a chair.)
 • Start with short periods of being out of bed and increase
as the client is able.
 The nurse can provide support to the weak or
unsteady person by using a transfer belt (also
called a gait belt). This belt is a sturdy webbed
belt with a buckle that easily secures around
the client’s waist. Explain to the client that
the transfer belt provides safety and
protection for both client and nurse. In
Practice: Nursing Procedure 48-4 discusses
considerations in the use of the transfer belt.
 Key Concept It is important to use a transfer
belt whenever assisting an unsteady weak,
faint, or partially paralyzed person to walk.
Preventing falls is a primary nursing function
for all nurses.
 Evaluating Fall Risk
 It is everyone’s duty to prevent clients from
falling
It is essential to use body mechanics while
making bed making to prevent muscle
strain in the body.
 Bend your knees not your back to keep the
center of gravity directly above and close to
the base of support and to help prevent
fatigue.
A person or an object is more stable if the
center of gravity is close to the base of support.
 Face your entire body in the direction that you
are moving and avoid twisting to prevent back
strain or injury.

 Organize your work. Smooth, rhythmical

movements at moderate speed require less
energy.
 Raise the bed to an appropriate height for
maximum working comfort to prevent fatigue.