Timby: Fundamental Nursing Skills and Concepts

Timby: Fundamental Nursing Skills and Concepts

Chapter 23 Body Mechanics, Positioning, and Moving Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false?

Good body posture distributes gravity through the center of the body over a wide base of support. Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True.

Good body posture distributes gravity through the center of the body over a wide base of support. A poor posture often results in muscle spasms. Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Introduction to Dangers of Inactivity

Inactivity leads to deterioration of health Disuse syndrome: signs and symptoms resulting from inactivity in as little as 24 hours Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Dangers of Inactivity Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Maintaining Good Posture Good posture affects a persons appearance, stamina, and ability to use the musculoskeletal system efficiently

Poor posture often results in muscle spasms Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Maintaining Good Posture (contd) Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Standing Posture Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which type of mattress provides minimal pressure reduction? a. Water

b. Static air c. Egg-crate foam d. Gel Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer c. Egg-crate foam Egg-crate foam mattress provides minimal

pressure reduction. A water mattress supports the body and equalizes the pressure per square inch over its surface. A static air pressure mattress suspends the client on a buoyant surface, distributing the pressure on the underlying tissue. Gel is an alternative substance used to fill cushions and mattresses.

Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Sitting Posture Correct sitting posture Buttocks and thighs base of support Both feet rest on floor Knees bent and clear of chair edge (Refer to Figure 23-3 in the textbook.)

Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Lying-Down Posture Good lying-down posture Head, neck centered between shoulders Shoulders level; arms, hips, knees slightly flexed Trunk straight; hips level; legs parallel; feet at right

angles to legs (Refer to Figure 23-4 in the textbook.) Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Body Mechanics Proper body mechanics Increase muscle effectiveness

Reduce fatigue Avoids repetitive strain injuries Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Ergonomics Definition: special field of engineering science devoted to the promotion of comfort,

performance, and health in the workplace Example: using assistive devices to lift or transport heavy items or clients; using alternative equipment for repetitive tasks Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients General principles for positioning

Change the inactive clients position at least every 2 hours Enlist the assistance of at least one other caregiver Remove pillows and positioning devices Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients (contd)

Common positions Supine position o Foot drop: permanent dysfunctional position caused by shortening of the calf muscles and lengthening of the opposing muscles on the anterior leg Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Foot Drop Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients (contd) Common positions (contd) Lateral Lateral oblique

Prone Sims and Fowlers Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Common Positions Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Question In what position should the infant be placed to reduce the incidence of sudden infant death syndrome? a. Lateral b. Supine c. Prone d. Sims

Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer b. Supine The infant should be placed in supine position to reduce the incidence of sudden infant death syndrome. Lateral position, prone position, and Sims position are not recommended to

reduce sudden infant death syndrome. Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Positioning Clients (contd) Positioning devices Adjustable bed Mattress Bed board (rigid structure placed under a

mattress) Pillows Roller sheets Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Adjustable Bed Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Positioning Clients (contd) Turning and moving clients Assistive devices and additional caregivers are needed when turning or moving a client who cannot change from one position to another independently

Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Trochanter Rolls Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Hand Rolls

Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Foot Boards, Boots, and Foot Splints Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Trapeze

Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which positioning device is foundational for good body alignment? a. Mattress b. Adjustable bed c. Pillow

d. Roller sheet Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer a. Mattress A positioning device foundational for good body alignment is a mattress. Adjustable beds allow changes in head and knee position.

Pillows are used to support and elevate a body part. A roller sheet that extends from the upper back to midthighs is used to slide and roll the client. Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Protective/Pressure-Relieving Devices

Side rails Mattress overlays Foam and gel mattresses Static air mattress Alternating air mattress Water mattress Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Protective/Pressure-Relieving Devices (contd) Cradle: metal frame secured to or placed on top of the mattress to protect feet and lower legs from bed linens Specialty beds Low air loss Air fluidized

Oscillating support Circular bed Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Oscillating Bed Slowly, continuously rocks from side to side in 124-degree arc Relieves skin pressure

Helps mobilize respiratory secretions (Refer to Figure 23-18 in the textbook.) Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Circular Bed Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Transferring Clients Examples of transferring aids Transfer handle Transfer belt Transfer boards Mechanical lift Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

Nursing Implications Nursing diagnoses for inactive clients Impaired physical mobility Risk for injury Risk for disuse syndrome Risk for perioperative-positioning injury Impaired bed mobility Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

General Gerontologic Considerations Older adults Need to maintain as much mobility as possible to prevent disability Require extra time and assistance during positioning, transferring, and ambulating Instructions should be given using clear,

simple words; make one request at a time Copyright 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins

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