NURSING ASSISTANT III Unit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and...
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Transcript of NURSING ASSISTANT III Unit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and...
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NURSING ASSISTANT IIIUnit 2 Chapter 11: Positioning, Lifting, and Transferring Patients and Residents
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POSITIONING PATIENTS AND RESIDENTS
Changing positions frequently helps us stay comfortable
Complications can arise from spending long periods of time in same position
Many reasons why person may not be able to change positions
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Integumentary System
Pressure ulcers (decubitus ulcers) (bed sores)
Where bony areas press against mattress
Very difficult to heal
Develop in 4 stages
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 1 Ulcer
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 2 Ulcer
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 3 Ulcer
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
Stage 4 Ulcer
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Musculoskeletal
Contractures
Stiffness
Atrophy
Calcium loss
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Respiratory system
Prevent lungs from completely filling with air
Atelectasis
Pneumonia
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Cardiovascular System
Venous return Blood clots
Stasis ulcers
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Cardiovascular System
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Cardiovascular System
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POSITIONING PATIENTS AND RESIDENTS
Serious Complications Cardiovascular System
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Proper positioning is necessary for proper body alignment
Spine should not be twisted or crooked
Most comfortable
Relives strain on muscles and spine
Helps prevent pressure ulcers
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Supine (Dorsal Recumbent) Position
Lying on the back
Bed is flat
Head supported by a pillow
Subject to pressure ulcers on the heels and sacrum Sand beds
Heels must be elevated
Place pillow under person’s calves
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Fowler’s Position
Similar to supine position with the head of the bed elevated to 45 and 60 degrees
Semi-Fowlers Head of bed 30-45 degrees
High-Fowlers Head of bed between 60-90 degrees
Knee-gatch area of bed may be elevated as well
Comfortable for reading, watching TV, talking with visitors, etc.
Good for management of certain diseases
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Lateral Position
Lying on the side
Must document which side person is laying on
Lower leg is straight
Upper leg is bent and supported by a pillow
Upper arm is supported by a pillow
Often used for people with back pain, or in a body cast
Part of the cycle of positions
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Prone Position
Lying on the abdomen with the head turned to the side
Pillow under the head, lower abdomen, and feet
Many people are not comfortable in this position
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Sims’ Position
An extreme side laying position that is almost prone
Head turned to one side with knee bent sharply on that side
Used for receiving enemas, and to relieve pressure on coccyx or greater trochanter
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Sitting Position
Feet should rest flat on the floor
Knees bent approximately 90 degrees
Buttocks and back against backrest
Arms should be supported
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POSITIONING PATIENTS AND RESIDENTS
Basic Positions Trendelenburg Position
Supine with feet above the level of the head
Used for patients with low blood pressure
Caution with head injuries Increases ICP
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POSITIONING PATIENTS AND RESIDENTS
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POSITIONING PATIENTS AND RESIDENTS
Repositioning a Person Some people require repositioning as frequently at ever hour
Most people require repositioning every 2 hours
Each time you reposition be observant to complications
People who you are moving are at higher risk for shearing and friction injuries
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POSITIONING PATIENTS AND RESIDENTS
Repositioning a Person Shearing
Caused by pulling a person across a sheet or other surface that offers resistance
The skin is dragged, injuring the underlying tissues and muscles
Leads to skin breakdown
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POSITIONING PATIENTS AND RESIDENTS
Repositioning a Person Moving person to side of bed
Moving a person up in bed
Raising head and shoulders
Turning person on side
Logrolling
Transferring to a stretcher
Using a mechanical lift