Position
- Choice position for patient with pressure sore on back sacrum.
- Used for tonsillectomy to promote drainage of secretion.
- Right lateral used in pyloric stenosis after meal to facilitate entry of stomach content into intestine.
- During lumbar puncher procedure to facilitate entry of needle into space between L3-L4.
“Fowler’s position"
It’s intervention used to promote oxygenation c maximum chest expansion.
- In COPD
- In thoracentesis.
- In post partum.
- Autonomic dysreflexia
- In nasogastric tube
- In abdominal aneurysm
- In CFH and pulmonary edema.
- In cataract surgery.
- In rupture appendicitis to prevent upward spread of infection.
- Used in paracentasis to facilitate removal of fluid in abdominal cavity.
“Trendelenburg position”
- Patient lies supine with head end 30-40 degree lower than the feet and
- used in postural drainage and promotion of venous return.
- Used in shock condition to promote venous return to the heart.
- Used during tube insertion for TPN (total Parcenteral nutrition) to prevent air embolism.
- Major complication is increased ICP and intra ocular pressure and hypotension.
1. Fowler position– 45 degree to 60 degree
High fowler position -80 to 90 degree (NG tube)
Low fowler position –up to 30 degree (increase I.C.P.)
Semi fowler -30to 45 degree
Contraindication – Brain & spinal cord injury.
Uses-
To prevent the dyspnea-(Pulmonary oedema caused by hypervolemia )
In this condition proper ventilation are not possible since recommended the up-right (fowler ) position to promote the lungs expansion.
Post partum Woman- For the uterine drainage by the gravity after delivery to prevent the ascending infection.
In CHF & pulmonary oedema– up right with high fowler sit the client at the edges of bed & legs in the dangling condition & foots are towards the floor & knee are banded condition so, to decrease the venous return and increase the peripheral vascular resistance and relief the fluid congestion in pulmonary edema & CHF condition.
Autonomic dysrythma- it is complication of S.C.I. at C5-C6 level which related with the respiratory problem. So provider the high fowler position priority – ventilation C/S- postural hypertension , abnormal skin flusjing above level of injury.
Oesophageal varicies bleeding – in this during insertion of singstaken blackmore tube provide high fowler position
Thorecentesis.
Cataract surgery
2.Prone Position- the client is lying on the abdomen & head turn to side.
Use-
To prevent Bed sore –( more chance of bed sore at sacral area).
To prevent aspiration-
Contraindication – Respiratory difficulty to chest .
3.Left lateral position –
Uses-
Air embolism condition –
To trap the emboli in the R.A.
To give enema
To insert Suppositery –( shape , internal body cavity , dissolve of body temp, & mix in systemic circulation.
To take the rectal temp.
4.Dorsal recumbent position –the client lie on his /her back & legs are seprated and knee flexed and sale of the feet flat on the bed.;
Uses- 1. Vaginal examination.
2.Catheterization
Lithotomy Position –
Rose position – Hyperextended condition of neck which is caused by placement of pillow under the shoulder during the use of tonsillitis & pharyngitis.
Knee chest position /kneeling position.
The client lies prone on the knee & chest and head is turn to one side with cheek on a pillow.
Tredlenberg position –
Lower part of bed is elevated apport 45 degree higher then the trunk L.P. me use –Shock & hypotension condition Postural drainage .
Reverse tredlenberg position-
Head of the bed are elevated higher then the to lower part of bed.
Angle B/w 30-45 degree at head of bed 10 sim’s position/ genuopectral.
Like left lateral
Special consideration –
Mastectomy – the client head of bed elevated and realted arm should also elevated with pillow –to promote lymphatic fluid return
To promote the lymph oedema
Amputation of lower extremity- In first 24 hrs after amputation ,elevate foot of bed ,stump is supported with pillow but not used for the elevation of stump to prevent flexion.
“Liver Biopsy”
- Right side position.
“Total hip replacement”
- maintain abduction
- Post operative exercise (foot) to prevent DVT
- Gastrochemius pumping
- Quadriceps (thigh setting)
- Foot circles
- Hip and knee movements.
Site – 9th to 10th I.C.S.
Biopsy – used to diagnose benign or malignant condition. A small part of tissue should be eradicated
Position –
Before the position- Position the client in supine position with right side of the upper abdomen exposed by placing the pillow under the 9th& 10th I.C.S.(if necessary )
The client Rt. Arm is raise and extended over the Lt. shoulder behind the head .
Liver is located in Rt. side in such type of position given maximum .explorationof I.C.S.
After the procedure – Assist the client in Rt. Side lying position. Place a pillow or folded towel under the puncture for max. 3-5 hr, to provide a pressure on puncture site & prevent bleeding .
Thyroidectomy-
Position – Before- Rose position
After- semi fowler position
To prevent the swelling of neck reduce
Peripheral Artery Disorder-(PAD)
C/S- Intermittent, claudication.
In arterial disorder swelling can prevent the arterial blood flow, given instruction to client to elevated their feet strate at rest condition .But should not arise of above the level of heart.
Cause slow arterial blood flow resistance making by gravity.
In Veins disorder- In vein disorder leg elevation above level of heart is advice.
Cataract surgery– world wide blindness.
Given the client position operative site to prevent edema.
Semi fowler position.
Aneurysm-
Position- Semi position with knee
Flexed –to reduce abdominal distension.
Lumber puncture- “C” shape position.
“Quickensted’s Test- to check the obstruction of CSF in L.P.
“C” shaped- Chin rest on the chest & knee on the Abdomen .
Tredlenberg position
Supine.
Renal Angiography-
Supine position is given till 8 hours.
In this dye is inserted through femoral artery to visualize renal .
Before admin allergy test is done.
In this semifowler position is avoided more then 45 degree becoz it cause bleeding .
Trochanter roll-
It is used in waliner position.
It delivery during engagement process in this trochanter roll is used the patient shift edges of bed and leg of patient flexed to wards the floor .
Hip dislocation –
Femur का Acetabulum से बहार आजाना
Complex
Partial
In this thick sound present
C/s- “ortolani sound”
Hip replacement-
Always maintain –abduction (Right)
Eg. Place a pillow b/w two legs
Place the pillow client non operative site
Avoid – Abduction (Wrong)
Eg- Cross the legs
Side lying position on non operative site.
Flexion & Dorsi flexion not allowed
Allow after 1 week.
GERD-(Gastro oesophageal reflex Regurgitation disease)
Reversed tredelburg position
Spinal cord injury-
“ stryker bed or faster bed”
Neck neutralized
Semi fowler position
Cervical biopsy- No pain in cervical biopsy.
No nerve
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