Body Posture & Lifting-8
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Transcript of Body Posture & Lifting-8
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NSK 1114
NURSING SKILL I
NOORSALFIZAH BINTI JAMIL
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POSTURE, BODY
MECHANICS AND
MOBILITY OF CLIENT ANDCAREGIVER
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NORMAL MOVEMENT
Equilibrium is a normal movement and
stability that are intact with:
1. Musculoskeletal system.2. Nervous system.
3. Inner ear structures.
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Normal movement (cont)..
Body movement required coordinated
muscle activity and neurologic integration.
It involves four basic elements:Body alignment (posture)
Joint mobility
Balance
Coordinated movement
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JOINT MOBILITY
Refers to the persons ability to move
freely.
Serves many purpose, such as expansionof an emotion with a nonverbal gesture,
self defense, satisfaction of basic needs
and performance of Activity of Daily Living
(ADLs) and recreational activities.
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Joint mobility (cont)..
Many function of the body need mobility to
function optimally. To maintain optimal
physical mobility, the musculoskeletal andnervous systems of the body must be
intact and functioning.
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IMMOBILITY
Refer to inability to move freely.
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ALIGNMENT AND POSTURE
Proper body alignment and posture bring
body part into position in a manner that
promotes optimal balance and maximal
body function (sitting, standing or lying
down)
A person maintains balance as long as the
line of gravity passes through the center ofgravity and the base of support.
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Alignment and posture (cont)..
In human, the usual line of gravity begins
at the top of the head and falls between
the shoulders, through the trunk, slightly
anterior to the sacrum and between the
weight-bearing joints and base of support.
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Alignment and posture (cont)..
When body is well aligned, strain on the
joints, muscles, tendons or ligaments is
minimized and internal structures and
organ are supported.
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Alignment and posture (cont)..
A persons posture is one criterion for
assessing general health, physical fitness
and attractiveness.
Posture reflects the mood, self-esteem
and personality of an individual.
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JOINT MOBILITY
Are the functional units of the
musculoskeletal systems.
The bones of the skeletal articulate at thejoints and attach to the two bones at the
joint.
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Joint mobility (cont)..
The muscles are categorized according to
the type of joint movement they produce
on contraction.
Muscles are called flexors, extensors, internal
rotators.
The flexor muscles are stronger than the
extensor muscles.
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Joint mobility (cont)..
When a person inactive, the joints are pulled
into a flexed (bent) position. If this tendency is
not countered with exercise and position
changes the muscle permanently shorten andthe joint becomes fixed in a flexed position
(contracture)
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Types of joints
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Joint mobility (cont)..
Range of motion (ROM) is the maximum
movement that is possible for that joint.
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BALANCE
Mechanisms involved in maintaining
posture are complex and involve
informational inputs from the inner ear,
from vision and from stretch receptors of
muscles and tendons.
Mechanisms equilibrium (sense of
balance) respond, frequently without orawareness to various head movements.
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Balance (cont)..
Under normal conditions the equilibrium
receptors in the semicircular canals and
vestibule, collectively called the vestibular
apparatus, send signals to the brain that
initiate reflexes needed to make required
changes in position.
The receptors, hair like cells, respond todisplacement of the head in any direction.
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Balance (cont)..
When the head moves, the fluid flow within
the vestibule and semicircular canals
stimulates sensory hair cells.
Information from these balance receptors
goes directly to reflect centers in the brain
stem. This enables fast reflexive
responses to body imbalance.
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COORDINATED MOVEMENT
The cerebellum coordinates the motor
activities of movements and basal ganglia
maintain the posture.
When a clients cerebellum is injured,
movement become clumsy, unsure and
uncoordinated.
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BODY MECHANICS
Is the term used to describe the efficient,coordinated and safe use of the body tomore objects and carry out the activities of
daily living.Using principles of body mechanics during
routine activity will prevent injury.
The nurse teaches a colleagues andclients families to lift, transfer or positionclients properly.
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PATHOLOGICAL INFLUENCES
ON BODY MECHANICS
For example:
Congenital defects (disorders of bones, joints
and muscles- Osteoporosis)
Central nervous system damage
Musculoskeletal trauma- bruises, confusions,
sprain and fracture.
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PRINCIPLE OF BODY
MECHANICS
The wider the base of support , the greater
the stability of the nurse.
The lower the center of gravity, the greaterthe stability of the nurse.
The equilibrium of the subject is
maintained as long as the line of gravity
passes through its base of support.
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Principle of body mechanic (cont)..
Facing the direction of movement prevents
abnormal twisting of the spine.
Dividing balance activity between armsand legs reduces the risk of back injury
Rolling, turning or pivoting requires less
work than lifting.
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Principle of body mechanic (cont)..
When friction is reduced between theobject to move and the surface on which itis moved, less force is required to move it.
Reducing the force of work reduce the riskof injury.
Maintaining good body mechanics reduce
fatigue of muscle groups.Alternating period of rest and activity helps
to reduce fatigue.
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LIFTING
Nurse should not lift more than 51 lbs
without assistance from proper equipment
and/ or other persons.
When a person lift or carries an object, the
weight of the object becomes part of the
persons body weight affects the location
of the persons center of gravity
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Lifting (cont)..
To counteracts this potential imbalance,
body parts (e.g. arm & trunk) move in a
direction away from the weight center of
gravity is maintained over the base of
support.
Holding the lifted objects as close possible to
the body avoids undue displacement of thecenter of gravity and achieves greater
gravity.
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Lifting (cont)..
Lifting involves movement against gravity.
The nurse must use the major group of the
thighs, knees, upper and lower arms,abdomen and pelvis to prevent back
strain.
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PULLING AND PUSHING
When pulling and pushing an object, a
person maintains balance with least effort
when the base of support is enlarged in
the direction in which the movement is to
be produced or opposed.
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PIVOTING
Is a technique in which the body is turned
in way that avoids twisting of spine (turn
90 degree in the desired direction )
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PREVENTING BACK INJURY
The major contributor is habitually poor
standing and sitting posture lordosis.
Overweight individuals who carry theirextra weight over their abdomen, pregnant
women and women who consistently wear
high-healed shoes are at risk
exaggerated lumbar.
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POSTURE, BODY MECHANICS
AND MOBILITY OF CLIENT AND
CAREGIVER (PROCEDURE)
MOVING / LIFTING
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MOVING IMMOBILITY CLIENT UP
IN BED (ONE NURSE)
Place client on back with head of bed flat.
Stand one side of bed.Remove pillow from under head and
shoulders and place pillow at head of bed
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Moving immobility client up in bed (cont)..
Begin at client feet. Face foot of bed at 45
degree angle. Place feet apart with foot
nearest head of bed behind other foot
(forward-backward stance). Flex knees
and hips as needed to bring arms level
with clients legs. Shift weight from front to
back leg and slide clients legs diagonallytoward head of bed.
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Moving immobility client up in bed (cont)..
Move parallel to clients hips. Flex knees
and hips as needed to bring arms level
with clients hips.
Slide clients hip diagonally toward head of
bed.
Move parallel to clients head and
shoulders. Flex knees and hips as neededto bring arms level with clients body.
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Moving immobility client up in bed (cont)..
Slide arms closest to head of bed under
clients beck with hand reaching under and
supporting clients opposite shoulder.
Place other arm under clients upper back.
Slide clients trunk, shoulders, head and
neck diagonally toward head of bed.
Elevate side rail.
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AUSTRALIAN LIFT
ASSIST CLIENT IN MOVING UP IN
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ASSIST CLIENT IN MOVING UP IN
BED (ONE OR TWO NURSES)-
AUSTRALIAN LIFT.
Remove pillow from under head andshoulders and place pillow at head of bed.
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Assist client in moving up in bed (cont)..
Face head of bed
Each nurse should have one arm under clientsshoulder and one arm under clients thighs.
Alternative position; one nurse clients upperbody. Nurses arm nearest head of bed shouldunder clients head and opposite shoulder; otherarms should under clients closest arm andshoulder. Position other nurse at clients lowertorso. The nurses arm should be under clientslower back and torso.
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Assist client in moving up in bed (cont)..
Place feet apart, with foot nearest head of
bed behind other foot.
When possible, ask client to flex knees
with feet flat on bed.
Instruct client to flex neck, tilting chin
toward chest.
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Assist client in moving up in bed (cont)..
Instruct client to assist moving by pushing
with feet on bed surface.
Flex knees and hips, bringing forearms
closer to level of bed.
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Assist client in moving up in bed (cont)..
Instruct client to push with heels and
elevate trunk while breathing out, thus
moving towards head of bed on count of
three.
On count of three, rock and shift weight
from front to back leg. At the same time
client pushes with heels and elevatestrunk.
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MOVE WITH DRAWSHEET
MOVE IMMOBILE CLIENT UP IN BED
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MOVE IMMOBILE CLIENT UP IN BED
WITH DRAWSHEET OR PULL SHEET
(TWO NURSES)
Place drawsheet or pull sheet under client
by turning side to side. Have sheet extend
from shoulders to thighs. Return client to
supine position.
Position one nurse at each side of client.
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Move immobile client up in bed with
drawsheet or pull sheet (cont)..
Grasp drawsheet or pull sheet firmly near
the client.
Place feet apart with forward-backward
stance. Flex knees and hips. Shift weight
from front to back leg and move client and
drawsheet or pull sheet to desired position
in bed.Realign client in correct body alignment.
LOGROLLING THE CLIENT
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LOGROLLING THE CLIENT
LOGROLLING THE CLIENT
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LOGROLLING THE CLIENT
(THREE NURSES)
Place pillow between clients knees.
Cross clients arms on chest.
Position two nurse on side to which the
client will be turned.P
osition third nurseon the other side of bed.
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Logrolling the client (cont)..
Fanfold or roll the drawsheet or pull sheet.
Move the client as one unit in a smooth,
continuous motion on the count of three.
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Logrolling the client (cont)..
Nurse on the opposite side of bed places
pillows along the length of the client.
Gently lean the client as a unit back
towards the pillows for support.
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ASSIST TO SITTING POSITION
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ASSIST TO SITTING
POSITION
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Assist to sitting position (cont)..
Place client in supine position.
Face head of bed at a 45 degree angleand move pillows.
Place feet apart with foot nearer bedbehind other foot, continuing 45 degreeangle to head of the bed.
Place hand further from client undershoulders, supporting clients head andcervical vertebrae.
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Assist to sitting position (cont)..
Place other hand on bed surface.
Raise client to sitting position by shifting
weight from front to back leg.
Push against bed using arm that is placed
on bed surface.
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SIT ON SIDEOF BED
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ASSIST TO SIT ON SIDE OF
BED
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Assist to sit on side of bed (cont)..
Turn client to side, facing you on side of
bed on which client will be sitting.
With client in supine position, raise head of
bed 30 degrees.
Stand opposite clients hips. Turn
diagonally so you face client and far
corner of foot of bed.
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Assist to sit on side of bed (cont)..
Place feet apart with foot closer to head of
bed in front of other foot.
Place arm nearer head of bed under
clients shoulder supporting head and
neck.
Place other arm over clients thighs.
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Assist to sit on side of bed (cont)..
Move clients lower legs and feet over side
of bed. Pivot toward rear legs, allowing
clients upper legs to swing downward.
At same time, shift weight to rear leg and
elevate client.
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TRANSFERRING FROM
BED TO
CHAIR
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Transferring for bed to chair (cont)..
Assist client to sitting position on side of
bed. Have chair in position at 45 degree
angle to bed.
Apply transfer belt or other transfer aids.
Ensure the client has stable nonskid
shoes. Weight-bearing or strong leg is
place forward, with weak foot back.
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Transferring for bed to chair (cont)..
Spread feet apart.
Flex hips and knees, aligning knees with
clients knees.
Grasp transfer belt from underneath.
Rock client up to standing position on
count of three while straightening hips and
legs and keeping knees slightly flexed.
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Transferring for bed to chair (cont)..
Maintain stability of clients weak or
paralyzed leg with knee.
Pivot on foot farther from chair.
Instruct client to use arm rest on chair forsupport and ease into chair.
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Transferring for bed to chair (cont)..
Flex hips and knees while lowering clientinto chair.
Assess client for proper alignment forsitting position. Provide support forparalyzed extremities.
Praise clients progress effort orperformance.
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THREEMAN LIFT
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THREE-P
ERSON ( THREE MAN LIFT )CARRY FROM BED TO
STRETCHER
Th ( th lift ) f
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Three- person ( three man lift ) carry from
bed to stretcher (cont)..
Three nurses stand side by facing side of
clients bed.
Each person assumes responsibility for
one of three area; head and shoulder, hips
and thighs and ankles.
Each person assumes wide base of
support with foot closer to stretcher in frontand knees slightly flexed.
Th ( th lift ) f
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Three- person ( three man lift ) carry from
bed to stretcher (cont)..
Arms of lifters are placed under clients head
and shoulder, hips and thighs and ankles with
fingers securely around other side of clients
body.Lifters roll client toward their chest. On count of
three, client is lifted and held against nurses.
On second count of three, nurses step back and
pivot towards stretcher, moving forward ifneeded.
Th ( th lift ) f
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Three- person ( three man lift ) carry from
bed to stretcher (cont)..
Gently lower client onto center of stretcher
by flexing knees and hips until elbows are
level with edge of stretcher.
Assess clients body alignment, place
safety straps across body and raise side
rails.
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THANK YOU