Skills in Clinical Nursing 8th Edition

Berman Solutions Manual

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10 POSITIONING THE CLIENT
Chapter 10 focuses on the knowledge and skills the nurse needs to
know to position, move, turn, and transfer clients safely.
Emphasis is on proper support, alignment, and safety of client and
nurse during positioning and transfer of clients.

SUGGESTED DISCUSSION QUESTIONS, LAB, AND CLINICAL

ACTIVITIES
1. What actions can nurses take to prevent back injuries while caring for clients?

2. Show students support devices (actual and/or pictures) and discuss how the device can
promote proper alignment.

3. What are the clinical indications for the following client positions: Fowler’s, Dorsal
Recumbent, Prone, Lateral and Sims’?

4. Show a picture/diagram of each client position and ask students to write down the name of
the position.

5. Have students read about the “Handle with Care”, “No Manual Lift”, and “No Solo Lift”
campaigns and discuss the professional implications.

6. What are safety issues for the nurse and the client when transferring clients?

7. What assessments would prompt you to request additional assistance before transferring a
client?

8. Discuss the three types of lifts: mobile floor-based lift, ceiling lift, and sit-to-stand lift.
When is it appropriate to use each of them.

9. Have students practice placing each other in each of the above lifts. Ask: If they were the
patient, would they feel safer with a nurse using a lift or with nurses doing the transferring
without a lift.

10. Have each student practice placing another student (client) in each of the five positions.
Check for proper alignment. Ask the student/client if they feel aligned and if they would
adjust themselves differently. If they do, discuss how alignment was changed did it
improve? What did the student learn from the change in position?
11. Have each student practice moving/turning a student/client in bed using a friction-reducing
device and transferring a student/client from bed to chair, chair to bed, while using a
hydraulic lift.

12. Develop scenarios describing clients with differing immobility situations and health needs.
Ask students to describe how they would position, move, turn, or transfer the client given
the information they have and why.

13. For testing purposes: develop client situations that would incorporate positioning, moving,
turning, and transferring of a client. When students have practiced all of the skills and are
ready for testing, ask each student to randomly select a client situation and test on the
identified skill.

14. Assign each student to spend several hours with a physical therapist to observe positioning
and transfer techniques.

115. During clinical, ask one or two students to talk with the nurse manager and ask if the unit
has a lift and what the policy is for using it. Have other students survey the nurses to find
out if they use lifts and the reasons why or why not. Discuss in clinical conference.

17. Assign students a client that needs to be positioned, moved, turned, and/or transferred.

FOCUSING ON CLINICAL THINKING

Consider This
1. As a nurse, what can you do to prevent back injury to yourself and others?
2. You are providing nursing care for a client who has the following equipment: two IVs
(one inserted into a central line and the other in a peripheral line), an indwelling catheter,
a nasogastric tube connected to suction, and a Hemovac drain. The client is scheduled to
go to the radiology department via stretcher. How will you facilitate the client being
moved to the stretcher without injury to the client or yourself?
3. You and another nursing student have turned a client with right-sided paralysis to a left
semiprone position. The client can understand what you say to him but he cannot express
himself verbally. He can appropriately move his head for “yes” and “no.” How will you
determine that the client is comfortable and in correct alignment after positioning him?
4. What would you do if a client who needs to be transferred from the bed to a chair exhibits
the following: expresses fear of falling, does not want to move because “it will hurt,” and
states “you are new and don’t know what to do”?