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What are some goals of proper positioning?
- prevent skin breakdown/pressure sores
- prevent contractures
- prevent nerve compression
- provides comfort and pain relief
- allows proper alignment and support
- ensures pt safety
- improves circulation
While in bed with the head elevated, how does this affect the pt?
- shearing effect of butt
- external rotation of LEs
- internal rotation of UEs
How often should a pts postition be changed?
every 2 hours
When should you assess a patients skin condition?
before and after positioning
How long before reddness on a bony prominence disappears?
What are some precautions of positioning?
- decreased sensation
- unable to move/adjust position
- minimal soft tissue protection over bony prominences
- unable to express self/communicate discomfort
- incontinence (maceration-skin wet and moist all the time)
How should a patient be positioned in supine?
- shoulders parallel to hips so spine is straight
- neutral neck
- pillows under knees (short term)
- towel roll under ankles to protect heels
What position can lead to decreased hip and knee extension range with prolonged positioning?
What position requires physician approval?
How should you position a patient in prone?
- shoulders parallel to hips so spines straight
- pillow under head; towel roll under forehead
- arms stay at sides
- pillow under abdomen
- towel roll/pillow under ankles to prevent plantar flexion
*hip flexion contractures
If taking a pt out of a w/c to place in prone, how long should you place them in this position?
30 mins twice a day
How do you place a position in sidelying position?
- requires lots of pillows, sheets, towel rolls
- neutral neck
- pillow placement depends on angle you want them in
- upper arm should be comfortable
- pillow between knees
- make sure scapula is protracted a little
How should a pt be positioned while sitting?
90 degrees at hip, 90 degrees at knees so feet are flat on the floor
What is another name for AKA, and what should you avoid?
avoid too much hip flexion and abduction
What is another name for BKA, and what should you avoid?
avoid too much hip and knee flexion
What should you avoid for hemiplegics?
avoid shoulder adduction and internal rotation, elbow flexion, supination, pronation
With what condition should you avoid any prolonged positioning?
What should you avoid for burn patients?
any position of comfort...need to stretch out skin
What type of sitting is 90degrees at hip with knees extended?
What is hook lying?
laying supine with knees bent
What position is the pt laying supine with the head down?
What is fowlers position?
upper body propped diagnonal and knees are bent
What is short sitting?
90degrees at hip and 90degrees at knee