POSITIONS USED IN NURSING PATIENT IN BED. Different positions are used in caring for patient or client in the hospital. Changing patient position is an essential part or aspects of nursing practice. It is important toassess mthe skin and provide skin care before and after a position changed. Two or more nurses may be required to change a patient position. When the nurse wants to change the patient’s position, he/she must 1. Make sure the mattress is firm 2. Ensure the bed is clean and dry. Wrinkled or damp sheet increase pressure sore formation 3. Change patient positions every two (2) hours especially for immobilized patient 4. Always obtain information from the patient to determine which position is most comfortable except for special cases PURPOSES OF CHANGING PATIENT POSITION To prevent muscle discomfort To undue pressure which can result in pressure ulcer To prevent damage to superficial nerves and blood vessels To improve or maintain muscles tone and stimulate postural reflexes To give comfort to patient and for safety vawNe TYPES OF POSITION A. DORSAL/RECUMBENT/SUPINE POSITION Can also be refer to as back lying position. Patient les flat on his back with head and shoulders slightly elevated with one soft pillow and the knee straight. Indications: This type of position provides full relaxation, it is use for physical examination, for acutely ill patients, examination of the rectum and vagina if the thigh are flexed contra-indication: patient that has undergone surgery of the breast and chest and abdominal, patient with chest infection, patient with long standing illness or those with neurological conditions e.g nerve problems(paralysis) B, SEMI-RECUMBENT/DORSAL ELEVATED POSISTION The patient lies on his back with his hed and chest raided with two or more pillows. Indieations: The position could be use full relaxation, physical examination, when patient just regained consciousness from effect of anesthesia, convalescent patient Contra-indications: unconscious patients, burns affecting the back, convulsion, bruises or wound on the buttocks or back, spinal cord injury. C. PRONE POSITION Patient lies face down, with one pillow under his head which is turned to one side, One arm lies beneath or below the pillow. The feet should or may be raised to prevent the toes from pressing into the bed. For over weight patient put a small pillow under the chest. Indications: to prevent pressure sore on the patient back. For unconscious patient so as to allow drainage of saliva. To prevent and relieve distension caused by flatulence from the anus. Contra. \dications: patient with chest pains, pregnancy abdominal pain, hydroceleD. E. FOWLER’S/UPRIGHT/CARDIAC POSITION The patient is placed in a sitting position, supported by pillow and back rest. pillow are usually arranged in an arm chair fashion so that the arms are supported. Sometimes a bed table is placed in front of the patient and padded with a soft pillow so that patient can have a change of position by leaning forward. indication: for nursing cardiac or heart problem patient, Use for patient with respiratory difficulties e.g asthma LATERAL POSITION (SIDE LYING POSITION) In lateral position the patient lies on his side with arms forward and his knees and hips are flexed. Is of two type LEFT AND RIGHT LATERAL POSITION. The common one use is the left type because most procedures are through left side except if contraindicated. The patient lies on the left side with small flat pillow under his head. The head is bent forward towards the chest and back flexed. Indications: use for giving enema (empty rectum), for insertion of suppositories/tablets for therapeutic purpose, for checking of temperature via rectal route, for examination of the rectum and vaginal. Contra indications: abdominal surgery, cardiac problem, chest infection, chest surgery SIM’S POSITION/SEMI-PRONE POSITION Patient lies partially prone and partially lateral position. The patient lower arm is behind him and the other arm in front of him been flex at the hip and knee while the lower leg is slightly flexed. Indications: rectal examination, examination of vagina, treatment of the rectum Contraindications: abdominal surgery, cardiac problems, unconscious patient, amputated lower limb patient, pregnancy patient, chest surgery LITHOTOMY POSITION Patient lies on her back with her hand supported with pillow, leg raised and flexed at the knee with limbs apart and rotated outwardly. Indications: vaginal examination, rectal surgery, repair of episiotomy, delivery of baby Contra indications: abdominal pain/surgery, injuries on the back, fracture of the lower limb, chest infections. GENUPECTORAL POSITION, Itis also called knee- chest position. Patient lies on her face, chest and knee with the knee brought down to the chest. Kneels and chest bears the weight of the body. The head is tuned to one side Indications: post- natal exercise, rectal examination, tetrological Fallot (to ease breathing) Contra indications: breast surgery, unconscious patient, paralysis of the limbs TRENDERLENBURG POSITION (HEAD-LOW POSITION) The patient lies on her back and the foot of the bed iselevated at 450 andle so that the patient's hips and legs are higher than her shoulder and head. * Indication: surgeryContra indications :abdominal pain/ surgery, chest and cardiac infection/ surgery/disease, convulsion, tonsillectomy