Patient

Positioning

Princess Melanie R. Ballo

POSITIONING A PATIENT
• Positioning of a patient refers to the
arrangement and placement of a
patient's body during medical
procedures, surgeries, or diagnostic
examinations. It involves selecting
and adjusting the patient's posture and
body alignment to ensure optimal
access, safety, comfort, and effective
delivery of healthcare.
PURPOSES
• To provide comfort to the patient
• To relieve pressure on various parts
• To improve circulation
• To prevent formation of deformity
• To perform surgical and medical
investigations
• To prevent pressure sores
• To provide proper body alignment
• To carryout nursing interventions
Importance of Proper Positioning

• For maintaining alignment

• Prevents bed sores or pressure ulcer
• Maintains the patients airway and
circulation
• Comfort of the patients
• Safety of the patients
• Prevents extreme lateral rotation
PRINCIPLES OF PROPER POSITIONING
• Maintain good patient body alignment. Think of the patient in bed as though he
were standing.
• Maintain the patient’s safety.
• Reassure the patient to promote comfort and cooperation.
• Properly handle the patient’s body to prevent pain or injury.
• Keep in mind proper body mechanics for the practical nurse.
• Obtain assistance, if needed, to move heavy or helpless patients.
 Fowler'
Indications: s
To relieve dyspnea
To improve
circulation To prevent
thrombosis
a bed position in which the Postoperatively
head and trunk are raised 45°
to
to 60° relative to the bed Contraindications:
(visualize a 90° right angle to After
assistbrain surgeries
orient your thinking) and the Increased intracranial
knees may or may not be drainage
pressure
flexed. from abdominal or
 Semi-
Fowler's
Indications:
To relax the muscles of the
abdomen, back and thighs.
To relieve tension on the
abdominal sutures
To promote comfort
A position of a patient Patient experienceless nausea in
which is lying in bed in a this position
supine position with the Lung Expansion
head of the bed at Cardiac or Respiratory Conditions
approximately 30-45 For patients with a nasogastric
degrees. tube
 High-
Fowler's
Indications:
When patient is
defacating Eating and
Swallowing Taking X-rays
Help with Breathing
the head and trunk are
raised 90°,
60° most Contraindications:
to and means often is Resting in a high
the client
upright sitting
at a right angle to the fowler positioncsn cause
bed
discomfort and increase
development of pressure
 Pron
Indications: e
This position used postoperatively to
prevent aspiration of saliva and mucus
Used in postoperative cases,
tonsils, vesicovaginal fistula and spinal
the client lies on the abdomen with cases
the head turned to one side. The hips To prevent bed sores
are not flexed. It is the only bed To relieve abdominal distention
position that allows full extension of Used for patientshavinginjuriesand
the hip and knee joints burns on back
The prone position also Contraindications:
drainage from the promotes This position
elderly is not
or patient well
with tolerated by
cardiovascularor
especially useful for mouth and is
unconscious the
respiratory problems
clients or those clients recovering from
surgery of the mouth or throat
 Supin
Indications: e
The usual position used by the patient
Used for examination of the chest
and abdomen

Contraindications:
the patient lies on his back Elderly patients
with his head and Patients with operation
shoulders are slightly on
abdomen, breast and thorax
elevated. One pillow is given Prone to hypostatic
under the head. pneumonia
His legs should be slightly Patients with long standing
flexed. A small pillow is placed illnesses and neurological
under his knees.
 Sim'
Indications: s
To relieve pressure in the
buttocks, scapula and heels.

used for rectal examinations

Used for vaginal

the client assumes a posture
examinations
halfway
between the lateral and the prone
positions. The lower arm is
positioned behind the client, and the Contraindications:
upper arm is flexed at the shoulder
Patients with deformities of the hip
and the elbow. Both legs are flexed in
or knee may be unable to assume
front of the client. The upper leg is
this position
more acutely flexed at both the hip
and the knee than is the lower one.
 Latera
Indications: l
•Lateral position is used for giving back
care enemas and colonic irrigation
•Used for examination of perineum or
rectum inserting suppositories
• For taking rectal temperature
• For change of position
In the lateral (side-
• Later position is a relaxing position
lying) position the client lies
• Giving back care
on one side of the body.
The lateral position is Contraindications:
good for resting and • After hip surgery
sleeping clients.
• After orthopedic surgery
 Lithotom
Indications: y
• This position is given during gynecological
examinations, treatments, and operations
on genitourinary system

• For delivery of baby

The patient lies on his back. • For rectal examinations and operations
The legs are separated and
thighs are flexed on the Contraindications:
abdomen and the
legs are on the thighs.
patient's buttocks are The Contraindications of this position are,
kept
edge of the table and legs the
are patients with arthritis or joint deformity
supported by stirrups. may be unable assume this position
 Knee-Chest or
Genupectoral
Indications:
Used for vaginal and rectal examination
Used in first aid treatmentin cord prolapseor
retroverted uterus
As exercise for postpartum and
gynecology patients
Contraindication
Patient rests on the
Patients with cardiovascular respirator
knee and the chest. The and problems cannot assume this y
head is turned to one side position
with one check on a pillow.
Contraindications:
Patients with cardiovascular and
A pillow is place under the
respiratory problems cannot assume
chest The weight is on
this position
the chest and knees.
 Trendelenburg
Indications:
Promote venous return Hypotensive
s .
patients it promotes
because can from
venous this position
return.
benefit
Postural drainage. Trendelenburg's position
is used to provide postural drainage of the
Trendelenburg's position basal lung lobes.
involves lowering the head Contraindications:
of the bed and raising
the
foot o the bed of the •Patient with an intracranial pressure
f (ICP) greater than 20 mm Hg or in whom
patient. The arms increased intracranial pressure should be
patient's avoided.
should be tucked at their
 Reverse
Trendelenburg
Indications:
Gastrointestinal problems. Reverse
trendelenburg is often used for patients
with gastrointestinal problems as it helps
minimize esophageal reflux.
Prevent rapid change of position.
Patients
with decreased cardiac output may
Reverse Trendelenburg's is
not tolerate rapid movement or change
a patient position wherein from a supine to a more erect position.
the the head of the Watch out for rapid hypotension. It can
bed is with the foot
elevated be minimized by gradually changing the
of
the bed down. It is patient's position.

the opposite of Contraindications:

Trendelenburg's position. Risk for Injury
 Orthopnei
c
Indications:
Patient with severe
dyspnea Cardiac patients
Patient with chest
drainage tubes
In the orthopneic Contraindications:
position, the client sits
either in bed or on the Spinal cond
side of the bed with an injury Head
overbed table across injury
the lap
Procedure :
1. SILENTLY RECITE A PRAYER.

2. PLACE PATIENT ON A FOWLER’S POSITION

2.1 Elevate head of bed 45 to 60 degrees.

2.2 Rest client’s head against mattress or pillows

2.3 Use pillows to support client’s arms and hands if

client does not have control of use on them.
Procedure :
3. PLACE CLIENT ON A SEMI- FOWLER’S
POSITION

3.1 Elevate head of bed 15 to 45 degrees

3.2 Rest client’s head against mattress of pillows.

3.3 Use pillow to support client’s arms and hands if client

does not have control of use of them.
Procedure :
4. PLACE PATIENT ON A HIGH- FOWLER’S
POSITION

4.1 Elevate head of bed 60 to 90 degrees.

4.2 Rest clients’ head against mattress of

Pillows

4.3 Use pillows to support client’s arms

and hands if client does not have control
use of them.
Procedure :
5. PLACE PATIENT ON AN ERECT
POSITION

5.1 Ask patient to stand beside the

bed.

5.2 Give slippers or place paper

towels at the floor.
Procedure :
6. PLACE PATIENT ON A PRONE POSITION

6.1 Assist client to lie on his abdomen

6.2 Turn client’s head to one side.

6.3 Support head with small pillow

6.4 Use pillows to elevate toes

Procedure :
7. PLACE PATIENT ON A SUPINE POSITION.

7.1 Place clients on his back with head of bed flat

7.2 Place pillow under client’s upper

shoulders, neck, or head.

7.3 Place small pillow or roll under client’s

ankles to elevate heels
Procedure :
7.4 Place foot board or firm pillows
against bottom of client’s feet.

7.5 Place pillows client’s pronated

forearms, and keep client’s upper arms
parallel to client’s body.
Procedure :
8. PLACE CLIENT ON A SIM’S POSITION

8.1 Help patient to lie on either on his right or left

side. patient to rest his left arm behind his
body.

8.3 The right arm is forward with the elbow flexed

and the arm resting on a pillow placed under the
head.

8.4 Assist client to bent right knee

Procedure :
9. PLACE PATIENT ON A DORSAL
RECUMBENT POSITION.

9.1 Assist client to lie on his back close to the

examining table

9.2 Separate the client’s leg and knees are

bent, the soles of the feet rest flat on the bed
or table.

9.3 Place a pillow under the head of the patient.

Procedure :
10. PLACE CLIENT ON A LITHOTOMY
POSITION

10.1 Follow first three step of the dorsal

recumbent position

10.2 Bring the buttocks close to the edge of

the table.

10.3 The knees are flexed and the feet are

supported in a stirrup
Procedure :
11. PLACE CLIENT ON THE KNEE- CHEST
OR GENUPECTORAL POSITION.

11.1 The patient rests on his knees and

chest.

11.2 The body is flexed approximately 90

degrees at the hips.

11.3 The head is turned at one side resting

on a pillow
Procedure :
11.4 The chest may be supported by a
small pillow

11.5 The arms are flexed at the elbows

and rests alongside the patient’s head.

11.6 The lower legs are perpendicular

to the thighs.
Procedure :
12. Record each position change and
include amount of assistance needed
and client’s response and tolerance.

13. Record and report any signs of

redness (e.g., in areas over bony
prominences).
Thank you!