Positioning and Ambulating an Adult Patient

Question 1

Why change the position of a patient?

Answer 1

1. To promote comfort and relaxation
2. To restore body function
3. Helps to improve GI function
4. Helps to improve respiratory function
   
   1. Greater lung expansion
   2. Relieves pressure on the diaphragm
5. Prevents deformities
6. Relieve pressure and prevent strain
7. Stimulate circulation
8. To give treatments!
9. improves a pts function to work on tunk and UE strength.

Question 2

Basic Principles of Patient Positioning

Maintain good patient body alignment by what?

Answer 2

• Think of the patient in bed as if he or she were standing(start with spine)
• Maintain patient safety
• Reassure the patient to promote comfort and cooperation
• Properly handle the patient’s body to prevent pain or injury

Question 3

Basic Principles of Positioning

Keep in mind proper body mechanics for yourself

Answer 3

1. Obtain assistance, if needed, for heavier patients or less-able patients
2. Follow specific orders-make sure you know from chart
3. Up ad lib (Ad libitum is Latin for “at one’s pleasure“)
4. Bedrest
5. OOB (out of bed)
6. Do not use devices (tractions/splints) unless ordered

Question 4

Log rolling techniques

Answer 4

1. Technique used for a patient whose body must be at all times kept in a straight alignment
2. Turning without twisting
3. Typically requires 2 people if manually rolling, 1 if the patient is able to assist you -so knees and shoulders stay in aglignment
4. When in the hospital, make sure the bed is flat
5. Maintain privacy throughout the procedure
6. Make sure the height of the bed is appropriate to your mechanics

Question 5

Rationale for Getting OOB

Answer 5

1. Preserve or improve muscles tone
2. Improve circulation, particularly in the lower extremities
3. Preserve pulmonary tissue and airway function
4. Preserve muscle and joint mobility

Question 6

Principles of Assisting Patients OOB

Answer 6

1. Reassure the patient of his or her personal safety against injury or over-exertion
2. If necessary, use a technician to assist you when getting the patient OOB or ambulating
3. Support the affected side or extremity of the patient when ambulating
4. Do not overtire the patient
5. Increase time up and ambulation distance gradually

Question 7

Principles of Leaving a patient OOB

Give as much thought as you do to getting them out of bed.

Answer 7

1. Lock all wheelchair or mobile parts prior to transferring to or from the bed
2. Stabilize anything that is moving
3. Place a signal cord or call bell within reach of the patient while he or she is up
4. Check on the patient (especially if they are BID) to see if they are ready to get back into bed

Question 8

Assisting the Patient in Ambulating

Answer 8

• Assist the patient to sit on the side of the bed
• Place a gait belt at ALL times
• Assist the patient to move to a chair, or to ambulate
  
  • Using assistive devices as needed

Question 9

Management of a Patient with Poor Balance

Answer 9

1. Attempt to stabilize the patient
2. You may have to brace the patient beside you or against you
3. Guide the patient to a chair or the bedside, if possible
4. If a fall begins to occur, guide them slowly to the floor

Question 10

Management of a Falling Patient

Answer 10

1. Assume a broad stance with one foot slightly forward
2. Grasp the gait belt firmly and allow the patient to slide down your leg
3. Ease the patient to the floor using your body as an incline
4. Lower your body along with the patient if necessary

Question 11

Controlled Fall

video

http://www.youtube.com/watch?v=ed5CY7mKqtg