POSITIONS

USED IN
NURSING
 General guidelines for client positioning

• Assess client skin frequently

• Turn client frequently

• Prepare a turning schedule for all patients

 Supine position
• Client lies on back; Pillows may be used under head,
knees and calves to raise heels off the mattress

Indications
• After spine surgery
• Alternative position for clients on bed rest
• Promote comfort
• During physical exam or any anterior examinations

Contraindications
• Clients with dyspnea or at risk of aspiration
Complications
• Cervical hyperextension
– Maintain correct alignment, pillows under
shoulder, neck and head
• Posterior flexion of lumbar spine
– Small pillow under lumbar curvature
• Hyperextension of knees.
– Small pillow under thighs to slightly flex knees
• Foot drop(plantar flexion)
– Maintain dorsal flexion with foot board
 Dorsal recumbent

• Client lies supine with knees flexed and separated,

soles of feet flat on bed.

• Fold sheet once across the chest

• Fold a second sheet crosswise over the thighs and

legs so that genital area is easily exposed

• Place pillow under head

• Indications
– Vaginal , Rectal, and pelvic examinations and
treatments.

• Contraindication
– Abdominal assessment because it contracts
abdominal muscles
 Knee-chest

• Also called genu- pectoral position

• Client lies prone with buttocks elevated and

knees drawn to the chest

• Head is turned to one side.

• Thighs are straight and lower legs are flat on bed.

Indication:
• To obtain better exposure of the vagina,
cervix, and rectum.

• To examine the bladder.

• To help correct retroversion of the uterus ie.

Bring uterus to normal position.

• To administer caudal and sacral anesthesia.

• Vaginal and rectal examinations/procedures

• Operative procedures on the vagina, rectum

and perineum.

• Operative deliveries
• Contraindication:
– Arthritis or other joint deformities

• NOTE: Do not leave patient alone; he/she may

become dizzy, faint, and fall
Procedure:
• Place patient in the prone position, then assist
her to kneel so that her weight rests on her
chest and knees.

• Turn head to one side and flex her arms at the

elbows extending, then to the bed in front of
her.
• Be sure the thighs are perpendicular to the
level of the head.

• Watch pulse and general condition of the

patient.
Knee-chest position
 Prone

• Face down position, pt lies on abdomen with head

turned to one side, arms may cushion the head or
may be flexed.

• Arms may be above head or along side body.

• Pillow is placed under chest, pelvis and ankles

• Indications:
– Alternative position for immobilized clients
– Promotes drainage from mouth or wound
– Helps prevent contractures of hips and knees.
– Treatment of the back
– Examining spine and back
• Contraindications
– Abdominal surgery
– Clients with respiratory (DIB) or spinal problems
– Unconscious pt

• Potential complications
– Cervical spine flexion
• Small pillow under head
– Hyperextension of spine, respiratory impairment
• Small pillow below diaphragm
– Foot drop
• Allow feet to dangle over end of mattress, lower legs on pillow
Prone position.
 Lithotomy

• Also called dorsal lithotomy or dorso-sacral

position

• Patient lies supine with hips flexed and heels

parallel to the floor.

• Feet above or at the same level as the hips

(often in stirrups), with the perineum at the
edge of an examination table
• Draping required for privacy.

• Both knees are flexed simultaneously and

supported on stirrups.

• Similar to dorsal recumbent, except that the

legs are well separated and thighs are acutely
flexed
• Indications:
– Vaginal and rectal examinations
– Used for examination of pelvic organs.
– Operative procedures on the vagina, rectum and
perineum.
– Deliveries and operative deliveries

• Causes difficulty in patients with arthritis or

joint deformity.
Lithotomy position on Speculum examination
Left: Lithotomy position on stitching of Vaginal walls.
 Trendelenburg’s

• Client lies supine with head 30-40˚lower than feet

• Indication:
– Postural drainage; promoting venous return
– Gynecological surgery and supra-pubic prostatectomy.
– To prevent shocks.
– To prevent or relieve post-partum hemorrhage.

• May cause hypotension

 Side-lying/lateral

• Client lies on the side with lateral aspects of lower

scapula and lower Ilium supporting most of body
weight.

• Pillows support and stabilize uppermost leg, arm,

head and back.

• Includes right lateral recumbent & left lateral

recumbent
• Right Lateral Recumbent
– Patient is lying on their right side.

• Left Lateral Recumbent

– Patient is lying on their left side.
• Indications:
– Relieves pressure on sacrum and heels
– Promote comfort

• Contraindications:
– After hip replacement

• Possible complication
– Lateral flexion of neck
• Pillow
 Sims(left lateral)
• Patient is on left side with right knee flexed against
abdomen and left knee slightly flexed.

• Semi prone position; upper arm is flexed at shoulder

and elbow, lower arm is positioned behind client;
both legs flexed in front of client with more flexion in
upper leg;

• Client lies on the side with weight distributed toward

the anterior ileum, humerus and clavicle.

• Pillows support flexed arms and legs.

• Indications:
– Promotes comfort especially in pregnant client
– Promotes drainage from mouth
– Prevents aspirations
– Reduces pressure on sacrum and greater
trochanter
– Rectal examination.

• Contraindication
– Leg injuries or arthritis.
 Fowler’s

• The patient is placed in a semi-upright sitting

position and may have knees either bent or
straight

• Pillows can be used under head and arms and

a footboard may be used
• Indications:
– Eases eating, talking
– Draining the pelvis esp in postpartum women.
– To prevent strain of abdominal muscles.
– To facilitate breathing in patients with cardiac or
respiratory problems.
– Post-operative nasal or thyroidectomy cases

• Contraindication
– After spine or brain surgery
 Types of Fowlers positions

• High Fowler's position

– Head is raised 80-90 degrees
• Fowler's/standard fowler’s
– 45-60 degrees.
• Semi-Fowler's position
– Head elevated 30-45 degrees.
• Low Fowler's position
– Head of bed is elevated 15-30 degrees
 Jackknife position

• Also called Kroaske or Bozeman

• Patient is placed on the stomach with the hips

flexed and the knees bent at a 90-degree and
the arms outstretched in front of the patient.
• Indication
– Operation on the rectum and coccyx

– Examination of the rectum

Thank you