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Positioning Patients
Positioning Patients for NCLEX RN
| Question | Answer |
|---|---|
| Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic, sense of impending doom) | Tturn pt to left side and lower the head of the bed. |
| Woman in Labor w/ Un-reassuring FHR (late decels, decreased variability, fetal bradycardia, etc) | Turn on left side (and give O2, stop Pitocin, increase IV fluids) |
| Tube feeding w/ decreased LOC | Position pt on rght side (promotes emptying of the stomach) with the HOB elevated (to prevent aspiration) |
| during Epdural Puncture | Side-lying |
| After Lumbar Puncture | Pt lies in flat supine (to prevent headache and leaking of CSF) |
| Myelogram | Pt lies in flat supine (to prevent headach and leaing of CSF)**monitor for seizures |
| Pt w/Heat Stroke | Lie flat w/legs elevated |
| During continuou Bladder Irrigation (CBI) | Position on side of affected ear after surgery (allows drainge of secreations) |
| After Cataract Surgery | Patient will sleep on unaffected side with a night shield for 1-4 weeks. |
| After thyroidectomy | Low or semi-fowler's, support head, neck and shoulders. |
| Infant w/ Spina Bifida | position prone (on abdomen) so that sac does not rupture |
| buck's traction (Skin Traction) | elevate foot of bed for counter traction |
| After Total Hip Replacement | DON'T sleep on operated side, DON'T flex hip more than 45-60 degrees, DON'T elevate HOB more than 45 degrees. Maintain hip abduction (moving away from the median plane) by separating thighs with wedge pillow or pillows. |
| Prolapsed Cord | Knee-chest position Trendlenburg |
| Infant w/cleft lip | position on back or in infanct seat to prevent trauma to suture line. While feeding, hold in upright positon |
| Chest Physiotherapy | client lie down prone, Hips elevated, instruct to take 2 deep breaths..before coughing |
| To Prevent Dumping Syndrome (post-operative ulcer/stomach surgeries) | Eat in reclining position, lie down after meals for 20-30 minutes (also restrict fluids during meals, low CHO and fiber diet, small frequent meals) |
| Above the knee amputation | elevate for first 24 hours on pillow, position prone daily to provide for hip extension. |
| Below Knee amputation | Foot of bed elevated for first 24 hours, position prone daily to provide for hip extension. |
| Detached Retina | client should lie on his back or on the unaffected side to reduce intraocular pressure on the affected eye.the nurse should approach the client from the unaffected side- to avoid starting him. NO Bending down, No hard coughing No sneezing,or an activiti |
| Administration of Enema | Position pt in left side lying (Sim's) with knee flexed |
| after supratentorial Surgery (incision behind hairline) | elevate HoB 3045 degrees |
| After Infratentorial surgery Incision at nape of neck) | position pt flat and lateral on either side. |
| during Internal Raiation | On Bedrest while implant in place |
| Autonomic dysreflexia/Hyperreflexia (s&sx: pounding headache, profuce sweating, nasal congestion, gooose flesh, bradycardia, hypertension) | Place client in sitting position (elevate HOB) first before any other implementation |
| Shock | Bedrest with extremities elevated 20 degrees, knees straight, head slightly elevated ( modified trendelenburg) |
| Head Injury | elevate HOB 30 degrees to decrease intracranial pressure |
| Patient hypertensive | position with HOB up this will drop B/P |
| Patient hypotensive | Keep bed flat |
| Pyloric Stenosis (4wk infant) | position on R side and HOB elvated to 60 degrees |
| Instestinal Obstruction | insertion of Salem Sump NG, Patient with HOB elevated 60-90 degrees |
| Post Bronchoscopy | place in semi Fowlers position |
| Pregnant Client recieved epidural B/P drops | Place left side with legs flexed***Never on back for Pregnant Lady |
| Chronic Bronchitis | Client with HOB 60 degrees |
| Post Angiogram | Nurse should positon client flat on his back with either affected leg extended to decrease circulation |
| Post Granmal Seizure | Place pt side lying with head extended |
| COPD | place client in High Folwer's for maximum ventilation |
| Acute Pulmonary Edema (s/sx persistant cough with pink frothy sputum (Cardinal sign)tachypnea, dyspnea, otrhopnea, restlessness, anxiety, inability to sleep, hypoxemia, cyanosis (later stages), crackles Confusion, stupor, S3 heart sounds, increased pulmo | Position the client in high-fowler's position with feet and legs dependant or sitting on the side of the bed to decrease preload |
| post Tonsilectomy | Positon child on his side to facilate drainage. Elevate the head of the child's bed when fully awake. ** Monitor for signs of bleeding, include frequent swallowing, clearing throat, restlessness, bright red emesis, tachycardia, and/or pallor *** priority |
| Post Thyroidectomy | positon patient in High Fowler's to decrease edema and swelling of the neck. Support head and neck with pillow or sandbags.When transfering support head. Have client avoid neck flexion or estension.**monitor for signs of hemorrage, watch for hypocalcemia |
Created by:
SweetDreamer08
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