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Body Mechanics, Mobility and Transfer techniques

Principles of Body Mechanics Always assess the situation before acting. Work at the appropriate height. Wide base of support (legs shoulder width apart). Lower center of gravity. Face direction of movement Use leverage, rolling, turning, & pivoting instead of lifting. Do not use back
Prone Body Position a body position in which one lies flat with the chest down and back up
Side-lying Body Position lateral recumbent position in which the individual rests on the right or left side, usually with the knees slightly flexed.
Supine Body Position lying down with the face up
Sims Body Position patient lie on their left side, left hip and lower extremity straight, and right hip and knee bent
Fowler's Body position patient is placed in a semi-upright sitting position (45-60 degrees) and may have knees either bent or straight
Dorsal recumbent body position position of patient on the back, with lower limbs flexed and rotated outward
Lithotomy Body Position patient lies on the back with the legs well separated, thighs acutely flexed on the abdomen, and legs on thighs; stirrups may be used to support the feet and legs
Knee Chest Position patient rests on the knees and chest with head is turned to one side, arms extended on the bed, and elbows flexed and resting so that they partially bear the patient's weight; the abdomen remains unsupported, though small pillow may be placed under chest
Trendelenburg Position patient is on the back on a table or bed whose upper section is inclined 45 degrees so that the head is lower than the rest of the body; the adjustable lower section of the table or bed is bent so that the patient's legs and knees are flexed
Rationale for Positioning Body Alignment. Pt comfort- reduces continuous pressure on pressure points Restoration of muscle tone Stimulation of respiratory & circulatory systems Improved elimination Improved psychological well being Facilitate diagnostic tests/surgical intervention
Assistive And Protective Devices Pillows, bed cradle (tent to hold sheet off pt's feet), foot board, trochanter rolls, hand rolls, hand-wrist splint, abduction pillow, side rail, sheep skin, draw sheet, trapeze bar
Key points of Positioning Turn pt at least every 2 hrs. Encourage or perform ROM when turning or bathing. Cushion pressure points. Maintain special mattress. Use assistive devices.
Assessment Pain, mobility, ROM, muscle strength & tone, body alignment, hx of falls, activity intolerance, gait, balance, comprehension, motivation, weight
Ambulation orders Dangling, up to chair, standing, bedside commode (BSC), Bathroom privileges BRP, unrestricted/up as lib. With assistive devices: cane, walker, crutches
Ambulating a pt Assess pt, assess environment, inform pt of transfer plan, use shoes or non-slip slippers, low positioned bed, keep path free of obstacles, avoid stepping/pulling on tubes, consult physical therapy, provide frequent rest periods
Ambulating a pt Cont Walk on pt's weaker side, use gait belt/stand behin pt with hands on each hip, do not allow pt to put arm around your shoulders or waist, have colleague follow with wheelchair, lower pt to ground if starting to fall and assess for injuries before moving
Falling Spread your feet, support and lower, concentrate on using your legs
Walking with a cane Least amount of support. Should be waist high. Pt should always have two points of contact with ground. Hold on stronger side-weak leg & cane move together to provide wide base of support. Straight leg cane-most common. Quad cane: more support
Walking with a walker Provides more support than cane. Used for generalized weakness. Adjusted below waist with arms flexed. Move walker with weaker leg. Walk into walker. Never let pt pull on walker to get out of bed/chairs- increase risk of falls
Walking with crutches Placement- 2 inches below axilla, 6 inches to side, 6 inches in front of foot. Gait based on pt's weight bearing ability
Four point crutch walk Provides stability for a pt who can bear weight on both legs. Leg is moved alternately with each opposing crutch. 3 points of support are on floor at all times
Three point crutch walk Requires pt to bear all weight on one leg. Move crutches forward unaffected leg forward. Traditional walk for pt in a leg cast
Two point crutch walk Pt must be able to bear at least partial weight on each leg. Crutches move forward at the same time as the opposing leg- crutch movements similar to arm motion during walking
Swing through and swing to crutch walk Frequently used by paraplegics who wear weight supporting braces on their legs. Both crutches are moved forward followed by swinging both legs forward. Swing through: advance feet past crutches. Swing to: advance feet to crutches.
Maneuvering the stairs Use one crutch and handrail. ascending: stronger leg ascends step first, crutch and affected leg follow. descending: place crutch on lower step, move weaker leg to lower step
Nursing Diagnoses Risk for injury, impaired physical mobility, activity intolerance, disturbed body image, acute/chronic pain, social isolation, impaired skin integrity
Created by: senmark