fundamentals in nursing

feren t P at ient

Dif tion s
Po si

Submitted By: Andrea Monique R. Galasinao

BSN-1A

Submitted to: Mrs. Rowena V. Manus

Clinical Instructor
 What is Patient Positioning?
To avoid the difficulties of immobility and injury, patient positioning include

effectively maintaining a patient's neutral body alignment by avoiding

hyperextension and severe lateral rotation. Positioning patients is an

important component of nursing practice and a licensed nurse's obligation.

Goals of Proper Patient Positioning

Maintain the patient's airway and circulation throughout the procedure
Prevent nerve damage
Provide comfort and safety to the patient
Prevent soft tissue or musculoskeletal and other patient injury
Maintaining patient dignity and privacy.
Allows maximum visibility and access.

Guidelines for Patient Positioning

Explain the procedure.
Encourage client to assist as much as possible.
Get adequate help.
Use mechanical aids.
Raise client’s bed.
Frequent position changes.
Avoid friction and shearing.
Proper body mechanics.
PATIENT POSITIONING
NURSING
POSITION WHAT WHEN CONCERNS

HOB 60-90°
During episodes
This may be

with the
of respiratory
uncomfortable to

patient
distress, when
maintain for an extended

sitting up in
inserting a
period, a patient may

bed nasogastric
slump over if they lack

tube, during oral

the strength to stay

intake with
sitting upright, and must

feeding
be repositioned within 2

precautions hours to prevent skin

breakdown if patient is

unable to reposition

themselves as High-

Fowler’s places quite a

bit of pressure on the

coccyx

HOB 45-60°
Facilitates
Minimal
with the
chest expansion

patient
so it is helpful

sitting up in
with patients

bed. Patient
who are having

lying on their
difficulty

back in bed,
breathing,

with HOB
during tube
reclined feeding

admininstation

because it

facilitates

peristalsis while

minimizing

aspiration risk.
HOB 15-30°
Necessary in
If a patient has

with patient
some
continuous tube feeding

lying on their
neurological and
infusing or trouble

back cardiac
managing secretions,

conditions, after
aspiration is a risk with

procedures or
prolonged positioning
surgeries to

facilitate

hemostatis at

the insertion site

(like a cardiac

cath with a

femoral

approach) or

drainage from

various drains

HOB flat,
Post
Many pressure points

patient on
procedures to
(including the top of toes

back maintain
from the sheet)

hemostatis at
therefore you must be

insertion site,
diligent in turning patient,

frequent
may be uncomfortable

position for
to maintain, increases

many surgeries apnea in OSA, avoid

after 1st trimester due

to the added pressure

on vena cava and

subsequent hypotension

HOB flat,
Not used
Not comfortable for

patient on
frequently; use as
long, difficult for full

stomach
a therapeutic
respiratory expansion,

with head
measure in
not easy to put a

to one side advanced ARDS,

patient into this

during and after

position (especially if

some surgeries they have multiple lines

and tubes)
Flat on back,
During CVC
Not ideal with increased

feet raised
(subclavian or IJ)
ICP, uncomfortable, if

higher than
placement, if an
patient is confused

head by 15-
air embolism is
putting them in this

30° suspected as it
position may increase fall

traps air in the

risk
right ventricle,

when positioned

this way with a

Valsava it can

convert

supraventricular

tachycardia,

during various

surgeries,
respiratory

distress to

increase

perfusion

Flat on back,
For some
Somewhat

head raised
surgeries or
uncomfortable, if

higher than
procedures,
patients are

feet by 15-
pre-surgery
confused it might be

30° intervention for

difficult to maintain

some vascular
them safely in this

surgeries, may
position for long

be used to
periods
facilitate

respirations in

patients who

need to lay flat

post-procedure,

reduces GERD

symptoms
Flat on back,
During or after
Minimal
knees bent,
various

rotated
surgeries, for

outwards,
comfort
feet flat on

the bed

(head/shoulde

rs typically on

a pillow)
Occasionally

Halfway
Must remember to turn

used with
between
patient on schedule
unconscious

lateral and

patients as it

prone
facilitates

drainage of oral
secretions,

pregnancy,

during enemas,

for patients who

are paralyzed as

it takes pressure

off of the hip

and sacrum

Sitting at the
Facilitates
Ensure patient

side of the
respiratory
can safely sit

bed, leaning
expansion,
back in bed;

over a table makes it easier

don’t leave

to breath in
unattended if a

patients with
fall risk and

respiratory
sitting at the

difficulty, and side of the bed

used during a

thoracentesis
 The patient’s
Commonly used
Nerve injuries during

hips are
for vaginal
procedures in the

flexed until
examinations
lithotomy position may

the angle
and childbirth. be minimized by

between the
careful attention to

posterior
proper patient

surface of
positioning, including

the patient’s
padding of exposed

thighs and
peripheral nerves,

the O.R. bed

avoiding unnecessary

surface is 80
tension on the hips

degrees to
and knees
100 degrees.

The patient’s

lower legs

are parallel

with the O.R.

bed.
Knee-chest
Knee-chest
Prone knee-chest

position, can
position is
position can be

be in lateral
assumed for a
embarrassing for some

or prone
gynecologic or
patients.
Knee-Chest position. rectal

examination.

Also known
Jackknife
Many pillows are required

as Kraske, is
position is
on the operating table to

wherein the
frequently used
support the body and

Jackknife patient’s
for surgeries
reduce pressure on the

abdomen lies
involving the
pelvis, back, and the

flat on the
anus, rectum,
abdomen. Jackknife

bed. The bed

coccyx, certain
position also puts

is scissored
back surgeries,
excessive pressure on
so the hip is
and adrenal
the knees. While

lifted and the

surgery. positioning, surgical staff

legs and
should put extra padding

head are low. for the knee area.

 In kidney
Kidney positions
Patient may fall off the

position, the
allows access
table at anytime until

Kidney Position
patient
and visualization
the position is secured.
assumes a
of the

modified
retroperitoneal

lateral
area. A kidney

position
rest is placed

wherein the
under the

abdomen is
patient at the

placed over a
location of the

lift in the
lift.
operating

table that

bends the

body. Patient

is turned on

their

contralateral

side with their

back placed

on the edge

of the table.

References:

Haws, B. J. S. (2021, July 28). Patient Positioning Pictures Cheat Sheet for Nursing Students. NURSING.Com.

https://nursing.com/blog/patient-positioning-pictures/

Patient Positioning: Sims Position, Fowler’s Position | Knowledge Center. (n.d.). Steris. Retrieved March 26, 2022, from

https://www.steris.com/healthcare/knowledge-center/surgical-equipment/complete-guide-to-patient-positioning

Vera, M. B. (2021, September 20). Patient Positioning: Complete Guide for Nurses. Nurseslabs.

https://nurseslabs.com/patient-positioning/#what_is_patient_positioning