Patient Positioning in Bed - Nurse Care.

There are different positioning for patient in bed such as Dorsal Recumbend, Lateral, Prone, Supine, Fowlers, Sim’s, Trendelenburg’s, Lithotomy, Erect or Standing and Knee-Chest Postition. Here, we list out their definition, purpose and procedure.

 

Dorsal Recumbend Position


Definition :

Patient lies on back, knees fully flexed, thighs flexed and externally rotated feet flat on the bed.
 

Purpose :



1. To examine vulva, vagina and the rectum.

2. To perform operative procedures on the vulva area.

3. To Catheterize the bladder.

Procedure :


1. Place the patient on his/her back.

2. Separate the legs.

3. Flex the knees.

4. Place the foot at flat resting on the bed.

5. Use one pillow under the head and shoulder.

 

Lateral (Right and Left) Position :


Definition :

 

Patient lies on left side with legs flexed at thighs. The upper leg is flexed more than the lower. A pillow is kept infront of the abdomen and at the back and one under the upper leg.


Purpose :



1. To give enema.

2. To change position for bed ridden patients.

3. To insert rectal suppositories.

4. To take rectal temperature.

5. To perform surgery on rectum.

 

Procedure :

 

1. Place the patient on his side with one pillow under the head.

2. Place both the arms in front of the patient.

3. Flex the lower leg slightly with upper leg half bend at the knees.

4. Use pillow to support the head, back, arms and abdomen.

5. Place one pillow between the knees to take the weight of the upper leg.

 

Prone Position

Definition :

A patient lies flat on abdomen. Head turned to side ways. One soft pillow is given under head. The heads are at the sides or beyond the head. An extra pillow is given under the ankles to keep toes from touching the bed.


Purpose :

 

1. To examine the back and spine.

2. To relieve pressure on bony prominence.

 

Procedure :

 

1. Place the patient flat in bed on the abdomen.

2. Place arms straight on his side.

3. Turn the face to one side.

4. Use a small pillow under the ankle.

 

Supine Position


Definition :


Supine position the patient lies on his back with his head and shoulders are slightly elevated. One pillow is given under the head. His legs should be slightly flexed. A small pillow is placed under his knees.

Purpose :

1. To provide complete bed rest.

2. To examine the abdomen.

3. To perform abdominal surgeries.

 

Procedure :

 

1. Place the patient flat on his back.

2. Support the head with pillow.

3. Place arms straight on his side or folded on the chest.

4. Place leg extended or slightly flexed with a pillow under the knees.

5. Use cotton rings at the elbow, heels and air cushions under the buttocks to prevent bed sores.

6. Use foot board for a bed ridden patient to prevent foot drop.

 

Fowlers Position

 

Definition :

Fowler’s position is a sitting position in which the head is elevated, at least, a 45 degree angle. Back rest and two pillows are used for the back and head.
 

Purpose :

1. To relieve dyspnoea.

2. To relieve pressure on abdominal sutures.

3. To drain fluids from the abdominal cavity.

4. To change the positions of the patient.

 

Procedure :

1. Place the patient in a sitting position.

2. Raise the head of the bed to an angle between 45 to 70 degree.

3. Maintain the position by use of extra pillows.

4. Support the arms on a pillow.

5. Use foot board to prevent foot drop.

6. Raise the knee with pillow to prevent patient from slipping.

 

Sim’s Position

Definition :

Sim’s position is similar to the lateral position except that the patient’s weight is on the anterior aspects of the patient’s shoulder girdle and hip. The patient’s lower arm is behind him and the upper arm is flexed at the shoulder and elbow.


Purpose :


1. It is useful for unconscious patient to prevent tongue falling back from the throat.

2. To examine the rectum.

3. Allow secretions to drain from the mouth.

  

Procedure :

 
1. Place the patient on his left side.

2. Keep the left arm behind the back and the head inclined forward.

3. Flex both the legs with the uppe knee higher than the left knee.

4. Place one pillow under the head with the left cheek on it.

 

Trendelenburg’s Position

Trendelenburg’s position, the patient lie on his back. The patient’s head is low. The foot of the bed is elevated at 45 degree angle. The body is on an inclined place and the legs hangs downward over the end of table.


Purpose :


1. Used in examination of the pelvic organs.

2. To treat shock.

3. For postural drainage.

4. To promote venous return.

5. To treat decreased blood pressure.

 

Procedure :

1. Explain the procedure to the patient.

2. Arrange the articles need at the bed side.

3. Provide privacy (if needed).

4. Place the patient lied on his back.

5. Elevate the foot end at 45 degree angle.

6. The body is on inched plane with hips higher than the bed.

7. The knees are flexed and the legs hang downward over the end of the table.

 

Lithotomy Position


The patient lies on her back. The legs are separated and thighs are flexed on the abdomen and the legs are on the thighs. The patient’s buttocks are kept the edge of the table and legs are supported by stir ups.

Purpose :
 

1. This position is given during gynecological examinations, treatment, and operations on genitourinary system.

2. For delivery of baby.

3. For rectal examination and operations.
 

Procedure :
 

1. Place the patient on her back with the legs raised and flexed.

2. Keep the buttocks resting at the edge of the bed.

3. Separate the knees.

4. Support the leg on the stir ups.

 

Erect or Standing Position

The client stand erect. This position should not be used for client who are weak, dizzy or prone to fall.

Purpose :


1. To assess posture, balance and gait.

2. Orthopedic examination.

3. Assessment of neurologic disorders.

Procedure :


1. Explain the procedure to the patient.

2. Align the patient’s body in good position.

3. Tell the client to stand erect.

4. Provide comfortable place to the patient.

 

Knee - Chest Position

 

Patient rest on the knees and the chest. The head is turned to one side with one cheek on a pillow. A pillow is placed under the chest. The weight is on the chest and knees.

 

Purpose :

To examine the rectum and vagina.

Procedure :

1. Place the patient on resting the knees and chest with little raised above the bed and keep the thigh at 90 degree angle.

2. separate the knees slightly.

3. Turn the face to one side on the pillow.

4. Flex the arms at the elbow to rest.

 

patient positioning in bed, nursing care

Patient Positioning in Bed - Nurse Care.

AUTHOR : AMRITA MONDAL