1. Nursing assistant III
Unit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and Residents

2. POSITIONING PATIENTS AND RESIDENTS
Changing positions frequently helps us stay comfortable
Complications can arise from spending long periods of time in same position
Many reasons why person may not be able to change positions
POSITIONING PATIENTS AND RESIDENTS

3. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Integumentary System
Pressure ulcers (decubitus ulcers) (bed sores)
Where bony areas press against mattress
Very difficult to heal
Develop in 4 stages
POSITIONING PATIENTS AND RESIDENTS

4. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 1 Ulcer
POSITIONING PATIENTS AND RESIDENTS

5. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 2 Ulcer
POSITIONING PATIENTS AND RESIDENTS

6. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 3 Ulcer
POSITIONING PATIENTS AND RESIDENTS

7. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 4 Ulcer
POSITIONING PATIENTS AND RESIDENTS

8. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Musculoskeletal
Contractures
Stiffness
Atrophy
Calcium loss
POSITIONING PATIENTS AND RESIDENTS

9. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
POSITIONING PATIENTS AND RESIDENTS

10. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
POSITIONING PATIENTS AND RESIDENTS

11. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Respiratory system
Prevent lungs from completely filling with air
Atelectasis
Pneumonia
POSITIONING PATIENTS AND RESIDENTS

12. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
POSITIONING PATIENTS AND RESIDENTS

13. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Cardiovascular System
Venous return
Blood clots
Stasis ulcers
POSITIONING PATIENTS AND RESIDENTS

14. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Cardiovascular System
POSITIONING PATIENTS AND RESIDENTS

15. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Cardiovascular System
POSITIONING PATIENTS AND RESIDENTS

16. POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Cardiovascular System
POSITIONING PATIENTS AND RESIDENTS

17. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Proper positioning is necessary for proper body alignment
Spine should not be twisted or crooked
Most comfortable
Relives strain on muscles and spine
Helps prevent pressure ulcers
POSITIONING PATIENTS AND RESIDENTS

18. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Supine (Dorsal Recumbent) Position
Lying on the back
Bed is flat
Head supported by a pillow
Subject to pressure ulcers on the heels and sacrum
Sand beds
Heels must be elevated
Place pillow under person’s calves
POSITIONING PATIENTS AND RESIDENTS

20. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Fowler’s Position
Similar to supine position with the head of the bed elevated to 45 and 60 degrees
Semi-Fowlers
Head of bed degrees
High-Fowlers
Head of bed between degrees
Knee-gatch area of bed may be elevated as well
Comfortable for reading, watching TV, talking with visitors, etc.
Good for management of certain diseases
POSITIONING PATIENTS AND RESIDENTS

22. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Lateral Position
Lying on the side
Must document which side person is laying on
Lower leg is straight
Upper leg is bent and supported by a pillow
Upper arm is supported by a pillow
Often used for people with back pain, or in a body cast
Part of the cycle of positions
POSITIONING PATIENTS AND RESIDENTS

24. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Prone Position
Lying on the abdomen with the head turned to the side
Pillow under the head, lower abdomen, and feet
Many people are not comfortable in this position
POSITIONING PATIENTS AND RESIDENTS

26. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Sims’ Position
An extreme side laying position that is almost prone
Head turned to one side with knee bent sharply on that side
Used for receiving enemas, and to relieve pressure on coccyx or greater trochanter
POSITIONING PATIENTS AND RESIDENTS

28. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Sitting Position
Feet should rest flat on the floor
Knees bent approximately 90 degrees
Buttocks and back against backrest
Arms should be supported
POSITIONING PATIENTS AND RESIDENTS

29. POSITIONING PATIENTS AND RESIDENTS
Basic Positions
Trendelenburg Position
Supine with feet above the level of the head
Used for patients with low blood pressure
Caution with head injuries
Increases ICP
POSITIONING PATIENTS AND RESIDENTS

30. POSITIONING PATIENTS AND RESIDENTS

31. POSITIONING PATIENTS AND RESIDENTS
Repositioning a Person
Some people require repositioning as frequently at ever hour
Most people require repositioning every 2 hours
Each time you reposition be observant to complications
People who you are moving are at higher risk for shearing and friction injuries
POSITIONING PATIENTS AND RESIDENTS

32. POSITIONING PATIENTS AND RESIDENTS
Repositioning a Person
Shearing
Caused by pulling a person across a sheet or other surface that offers resistance
The skin is dragged, injuring the underlying tissues and muscles
Leads to skin breakdown
POSITIONING PATIENTS AND RESIDENTS

33. POSITIONING PATIENTS AND RESIDENTS
Repositioning a Person
Moving person to side of bed
Moving a person up in bed
Raising head and shoulders
Turning person on side
Logrolling
Transferring to a stretcher
Using a mechanical lift
POSITIONING PATIENTS AND RESIDENTS