POSITIONING

Heart Failure (CHF)

• Fowler's position (HOB 45°)

Deep Vein Thrombosis

• patient is on bed rest, the feet and lower legs should be elevated periodically above the level of the heart

• Position allows the superficial and tibial veins to empty rapidly and to remain collapsed

Peripheral arterial disease (PAD)

• Lower the extremities below the level of the heart

• Dependency of lower extremities enhances arterial blood supply

Enema Administration

• pt on the left side (sims position)

• Facilitates flow ow of solution via gravity into rectum and colon, optimizing solution retention

NG tube placement

• High fowler's position (HOB 45-90°)

• More natural position for swallowing and protects against bronchial intubation aspiration

Enteral tube feeding

• HOB 30 to 45° or as near normal position for eating as possible

• Minimizes possible risk of reflux and aspiration into trachea

• Pts who are at high risk for aspiration should be assisted to be at least a 45° position

Pressure injury prevention

• Pts should be positioned laterally, prone, and dorsally in sequence unless a position is not tolerated or is contraindicated

• Those who experience discomfort after 30 to 60 minutes of lying prone need to be repositioned

• Pts. able to shift their weight every 15 to 20 minutes and move independently may change total position every 2 to 4 hours

• Routine repositioning every 2 hours or more frequently include loss of sensation, paralysis, coma, and edema

• Bridging technique: relieve pressure over bony prominences accomplished through the correct positioning of pillows

Active and passive range of motion

• Flat position or as low as the pt can tolerate

• Perform exercises slowly and gently, providing support by holding areas proximal and distal to the joint

Transferring patients

• Flat position or as low as the pt can tolerate

• Pt. folds arms across chest and chin to chest

• Reduces friction and prevents hyperflexion of neck