Republic of the Philippines Pamantasan ng Cabupao (University of Cabuyao) COLLEGE OF HEALTH AND ALLIED SCIENCES Katapatan Mutual Homes, Bry. Sanay Sandy, Cy of Cabuyeo, Laguna A025 BACHELOR OF SCIENCE IN NURSING Fundamentals of Nursing Practice Checklist Evaluation TOPIC Ill: ACTIVITY, MOBILITY AND EXERCISE POSITIONING AND DRAPING Name: YrJSection/Grp: Rate: Objective: ‘© Demonstrate the ability to use correct technique of placing the patient on bed or ‘examination table safely, comfortably, conveniently and effectively in preparation in any procedure. © Demonstrate the proper manner of draping the patient. Rating Scal 5 ~The student demonstrates the procedure with thorough in independent manner 4~ Demonstrate the procedure with minimal guidance and supervision 3~ Demonstrate the procedure with frequent guidance and supervision 2- Demonstrate the procedure with errors even with frequent guidance and supervision ‘1— Does not demonstrate the procedure even under close supervi guidance A. Erect (Standing or Up-right) Preparation STatsTaya Remarks 1. | Assemble the equipment and supplies: ‘* Clean gown or disposable gown | Draping sheet Procedure 1. | introduce yourself and verify your client's identity. sea] 2. | Explain to the client what you are going to do, why it is necessary and how she can cooperate 3. | Wash hands and observe other | | appropriate infection control procedure | | 4._| Provide for client's privacy &. | Adjust the examination table or bed of the patient. | 6. | Assist the patient to stand with their ] | slippers on or | | |_with bare feet on piece of paper.Place the chair one side where hand of patient can rest for support. For vaginal examination, elevate one foot on a low stool and separate them a far as itis comfortable for patient. Untie the gown and leave the uppermost tie. Fold the back gown over the shoulders toward the front. To compute for the Total Score: Add each item's rating. To compute for the Average: Divide the total SCORE by total number of items, ‘multiply by 100 Total Score Ave. B. Sitting Position Procedure Introduce yourself and verify your client's identity. Explain to the client what you are going to do, why itis necessary and how she can cooperate Wash hands and observe other appropriate infection control procedure Provide for "The buttocks are firmly on the edge of the bed or at the foot of examination table The thighs are well supported The knees should be bent and the feet should be positioned flat against the floor or a foot rest ‘A gown may use to cover the upper body. 10. ‘A drape or draw sheet covers the waist and legs | To compute for the Total Score: Add each item's rating. ‘To compute for the Average: Divide the total SCORE by total number of items, ‘multiply by 100 Total Score Ave. seeeeeeed 50C. Horizontal Recumbent Position (Supine Position) Preparation ol ‘Assemble the equipment and supplies: ‘+ Clean gown or disposable gown Draping sheet Procedure 1: Introduce yourself and verify your Client's identity. Explain to the client what you are going to do, why it is necessary and how she can cooperate Wash hands and observe other | appropriate infection control procedure Provide for client's privacy ‘Adjust the examination table or bed of the patient. Assist the patient lie on his back with legs extended or slightly flexed to relax the abdominal muscle. | Place pillow under the head and smaller | one may be placed under the knees for support. Arms will be crossed on the chest and comfortably flexed on the side above the head or lie loosely at the sides of the body Put the sheet over the patient covering the body completely from the neck to the shoulders downward with tucking it under the mattress. Note: If the patient is lying on his bed, replace the top sheet with a draping sheet (or top sheet may be used in the absence of the draping sheet) ‘To compute for the Total Score: Add each item's rating. To compute for the Average: Divide the total SCORE by total number of items, ‘multiply by 100D. Dorsal Recumbent Position Performed Preparation Fess Remarks ‘Assemble the equipment and supplies: 0 Clean gown or disposable gown | | Draping sheet | | Procedure [ Introduce yourself and verify your |_ client's identity. | 2. | Explain to the client what you are a. | going to do, why it is necessary and | how she can cooperate 3. | Wash hands and observe other - | appropriate infection control procedure 4.__| "Provide for client's privacy 3 | %. | Adjust the examination table or bed of |_ the patient. 6. Assist the client to lie flat on his back 7 I 7 ‘Separate the legs flex the knees so that | Ties the soles of the feet are flat on bed. | | 8. | Place he arms either above the head ] or flex with the hands on the chest | 9. _|_Place one pillow under the head | . ia 10. | Bring the buttocks of the patient to the 1 lee edge of the bed 11. | Place the draping sheet diagonally on ti the patient so that the opposite | corners cover the legs. Fold back the | | top corner over the chest. 4 |42.| Wrap comer on the right side around | the right foot. Do the same with the left side. I 13. | Fold the lower comer of the sheet back | i : on the sheet back on the abdomen to expose the part to be examined when the doctor is ready to do so. aa To compute for the Total § To! | Total Score item's rating. Ave. ‘To compute for the Average: Divide the total | SCORE by total number of items, multiply by 100 | E. Dorsal Lithotomy Position z | : ack Performed Preparation elas ras Remarks a5 ‘Assemble the equipment and supplies: ae oz 5 Clean gown or disposable gown 4. Draping sheet | Procedure |Introduce yourself and verify your client's identity. 2. | Explain to the client what you are | going to do, why it is necessary and how she can cooperate 3. | Wash hands and observe other appropriate infection control procedure | 4._|_ Provide for client’s privacy | 5. Adjust the examination DR table - 6. | Assist the patient to lie on her back . Insert the legging stockinette’s (PRN) 8. Adjust the stirrups according to the |_ size of the patient 9. ‘Separate the legs and flex the thighs deeply toward the abdomen | 10. Draw down the buttocks to the i following edge of the table i 11._| Raise the arms above the head or flex them with he hands on the chest. 12. Drape as in dorsal recumbent. Preferably, use the lithotomy drape. total SCORE by total number of items, | multiply by 100 | To compute for the Total Score: Add | Total Score each item's rating. | | Ave, ‘To compute for the Average: Divide the 85F. Sim’s Position (Sims Lateral Position) _ ] Preparation Bra este Remarks 1. | Assemble the equipment and suppli | Clean gown or disposable gown | | © Draping sheet | | Procedure 1. | Introduce yourself and verify your eal client's identity. | Explain to the client what you are going | | todo, why itis necessary andhowshe | | can cooperate | | | 3. | Wash hands and observe other appropriate infection control procedure 4, | Provide for client's privacy _ & | §. | Adjust the examination table or bed of | | the patient. 6. | Assist the patient to lie on the left side | with the body inclined forward | Extend the left arm behind the back and | | flex the elbow of the right arm forward Flex the thigh towards the abdomen | with the knee drawn up higher than | the left knee which is only slightly | flexed 9. | Lay out the draping sheet as in | horizontal recumbent position. Fold | back and or gather a side of the sheet | | to expose the area to be examined | To compute for the Total Score: Add | Total Score each item's rating. | | To compute for the Average: Divide the i total SCORE by total number of items, | mutiply by 100 "G. Prone Position Preparation ees ea Remarks 4. | Assemble the equipment and supplies: | | Clean gown or disposable gown | Draping sheet | | | | | Procedur e 4. | Introduce yourself and verify your | client's identity. 2 | Explain to the client what you are going | to do, why it is necessary and how she can cooperate 3. | Wash hands and observe other _ | ]|_ Provide for client's privacy 5. | Adjust the examination table or bed of the patient. 6. | Help the patient to assume the horizontal | recumbent position. 7. | Assist him to turn over onto the abdomen 8. | Turn the head to one side 9. | Place the arms at the sides or flex r |_ extend upward 10 | Allow the feet to hang over the edge of the mattress or support on a pillow high enough to keep the toes from touching the bed. [41] Drape as in horizontal recumbent -_|_ position. | To compute for the Total Score: Add Total Score | each item's rating. Ave. To compute for the Average: Divide the total SCORE by total number of items, muttiply by 100 H. Fowler's Position Preparation < | ‘Assemble the equipment and supplies: | Clean gown or disposable gown Draping sheet Procedur e 1. | Introduce yourself and verify your t's identity. 2. | Explain to the client what you are going to do, why itis necessary and how she can cooperate ‘3. | Wash hands and observe other appropriate infection control procedure 4. | Provide for client’s privacy 6. | Adjust the examination table or bed of the patient. 6. | Place the patient in a horizontal recumbent position 7. | Elevate the head of the bed to approximately 45° angle | 8. | Flex the knees slightly and support them ee with knee rolls. 9. | Drape as in horizontal recumbent position| To compute for the Total Score: Add | ] T | Total Score each item's rating. Ave. To compute for the Average: Divide the | total SCORE by total number of items, | 50 ‘multiply by 100 | I. Prone Position Preparation hyapsyaa Remarks Assemble the equipment and suppl Clean gown or disposable gown | Draping sheet L Procedure 4. | Introduce yourself and verify your client's identity. 2. | Explain to the client what you are going to do, why itis necessary and how she can cooperate 3. | Wash hands and observe other | appropriate infection | control procedure | | (4. | Provide for client's privacy T T . 5. | Adjust the examination table or bed of | the patient. Assist the patient to Horizontal recumbent position Elevate the foot of the bed so that the higher than the head and 8._| Support the shoulders and knees 9. | Drape as in horizontal recumbent each item's rating To compute for the Average: Divide the | total SCORE by total number of items, | ‘multiply by 100 Knee-Chest Position To compute for the Total Score: Add | Total Score Preparation Seace sca Remarks % ‘Assemble the equipment and suppli Clean gown or disposable gown Draping sheet Procedure 1, | Introduce yourself and verify your it’s identity. 2. | Explain to the client what you are going | | todo, why itis necessary andhowshe | | Neecan cooperate Wash hands and observe other appropriate infection control procedure Provide for client's privacy Adjust the examination table or bed of the patient. Place the patient on a prone position Assist him to kneel with knees slightly separated. Bend forward so that the chest is resting on the bed and the thighs are perpendicular to the legs Turn the head to one side and place the arms either above head or flex at the elbow and rest along the side of the head (0 Drape as in dorsal recumbent To compute for the Total Score: Add each item’s rating. To compute for the Average: Divide the total SCORE by total number of items, ‘multiply by 100 |) Total Score | Ave. | 155 Reference: Berman, A, Snyder, S., & Frandsen, G. (January 5, 2016) Kozier and Ers's Fundamentals of Nursing: Concepts, Process, and Practice Tenth Edition New Jersey: Pearson Education, Inc, ISBN-13: 978-0-13-397436-2 pg. S16 Comments Student's Signature over Printed Name C's Signature over Printed Name