LAB #2 ORANGEBURG-CALHOUN TECHNICAL COLLEGE DH/2017

ASSOCIATE DEGREE NURSING PROGRAM

NUR 101: Fundamentals of Nursing

Moving and Positioning

Purpose:
1. To promote mobility and exercise in patients needing assistance with activity.
2. To prevent complications associated with restricted activity.

Procedure: Wash hands.

1. Moving a patient closer to one side of a bed:
a. Slide your hands and arms under the patient's head and shoulders and pull toward you.
b. Move your hands and arms under patient's hips, and pull toward you.
c. Slide your hands and arms under patient's legs, and pull toward you.
d. Repeat in sequence until patient is in correct position.
2. Moving a patient up in bed: one-person assist:
a. Have patient bend knees and place soles firmly on bed.
b. Have patient grasp overhead trapeze, side rails, or headboard.
c. Slide your hands and arms under patient's hips, facing foot of bed, outside foot ahead of inside
foot.
d. Instruct patient to move with you at count.
e. On count, patient pulls with arms and pushes with feet as you pull.
3A. Moving a patient up in bed. Two- or three-person assist:
a. Move patient close to one side of bed.
b. If able, have patient's knees bent and soles firmly on bed.
c. Nurse 1 slides arms under patient's head and shoulders.
d. Nurse 2 slides arms under patient's hips.
e. Nurse 2 counts, and both move patient.
B. Moving a patient up in bed. Two or more persons – with use of lift sheet (draw sheet or lift
pad)
Patients that require assistance in moving should have bed lines utilized to assist in proper
handling. According to the institution policy or nursing judgment either a lift pad or draw
sheet should be applied during bed making.
a. Assist positioning the patient on lift linen.
b. Roll the linens toward and close to the patient’s body. One nurse each side of bed.
c. Grasp rolled linens firmly keeping arms spread to maintain good body mechanics.
d. On count both lift the patient and take a step sideways toward the head of the bed.
e. Repeat as necessary until patient is in correct position.
4. Turning a patient in bed: back to side:
a. Move patient to one side of bed.
b. Raise rail and move to other side.
c. Prepare pillows for support.
d. Turn lower body using one of two methods described.
e. Move patient's near arm out of patient's way.
f. Place patient's far arm across chest.
g. Grasp patient behind far shoulder.
h. Roll patient toward you.
i. Adjust position as needed.
5. Turning a patient in bed: back to abdomen:
a. Move patient to edge of bed.
b. Raise side rail and move to other side of bed.
c. Prepare pillows for support.
d. Place patient's near arm close to body.
e. Turn patient's face away from you.
f. Roll patient onto side.
g. Check arm and face positioning.
h. Roll patient further onto abdomen.
 i. Adjust position as needed.
6. Turning a patient: logrolling:
a. With help, move patient to side of bed in one unit.
b. Raise side rail on that side of bed.
c. All assistants move to other side of bed.
d. Place pillows correctly.
e. Assistants reach across and grasp patient's body.
f. At count, all turn patient in one unit.

Note: All the movements described can be facilitated by using a draw sheet or lift pad.

7. Supine position:
a. Place patient on back, with spine in straight alignment.
b. Place low pillow under head.
c. Place arms at side or elevated on pillow, with hands prone.
d. Place hand rolls if needed.
e. Keep legs straight.
f. Place trochanter or ankle roll on one or both sides.
g. Position feet with toes pointed up and support with footboard, sandbags, or carton.
8. Side-lying position: (Left or right)
a. Turn patient on side.
b. Place low pillow under head.
c. Under tuck pillow along back.
d. Place lower arm forward of body.
e. Flex and support lower arm on pillow used for head.
f. Flex top arm and rest on pillow in front of body.
g. Place hand rolls if needed.
h. Flex top leg and bring slightly forward.
i. Place pillow lengthwise between legs.
j. Support feet with positioning aids to prevent plantar flexion.
9. Fowler's position:
a. Place patient in supine position.
b. Elevate head of bed 18 to 20 inches.
10. Semi or Mid-Fowler's position:
a. Place patient in supine position.
b. Elevate head of bed 30-45º degree.
11. High-Fowler's position:
a. Place patient in supine position.
b. Elevate head of bed to greater than 45 degree angle.
12. Orthopneic position:
a. Have patient sit up in bed with over-bed table across lap.
b. Pad table with pillows and elevate to comfortable height.
c. Have patient lean forward with head and arms resting on table.
13. Lithotomy position: (Vaginal Exam)
a. Position patient on back.
b. Raise knees and separate legs.
c. If on table, place feet in stirrups.
14. Sim's position: (Right or left) (*LEFT Sim’s/ENEMA Position)
a. Use side-lying position, with single pillow only under head.
b. Turn far enough onto abdomen so underarm extends behind patient's back.
c. Patient is more on abdomen and chest than side lying. The upper leg is flexed and the lower leg
extended.
15. Knee-chest position: (Colonoscopy)
a. Have patient kneel on bed or table with hips in air.
b. If special table, have patient kneel on platform with head on table. (Table will tilt)
 16. Trendelenburg position:
a. Position patient on back with head lowered at 45 degree angle.
17. Prone position:
a. Place patient on abdomen.
b. Turn patient's head to one side.
c. Straighten spine.
d. Place folded towel under each shoulder.
e. Place arms flat at side or flexed at elbow near patient's head.
f. Place hand rolls if needed.
g. Place flat pillow or folded sheet under lower leg to elevate and allow toe freedom/mobility or can
move patient down in bed extending toes over foot of mattress.
18. Shock position:
a. Place patient on back with the arms extended along side the body.
b. Remove pillow from under the head.
c. Step down to the foot of the bed.
d. Grasp the metal bar on the bed frame.
e. Quickly lift the bed frame up until you hear the snap of the bed latch lock into place.
f. Turn loose of the bed frame. The patient’s feet and lower legs will be elevated.
g. The hips will be flexed and the buttocks, back and shoulders (Torso) should be flat on the bed.
19. Dorsal Recumbent Position:
a. Place patient on back with the spine in straight alignment.
b. Place pillow under head.
c. Extend the arms along side the trunk or flex to position of comfort.
d. Flex the patient’s knees placing the feet flat on the bed.
e. True dorsal recumbent position leaves the bed flat with the knees flexed.
20. Positioning a patient in a chair:
a. Place feet flat against floor.
b. Position knees and hips at right angle.
c. Straighten spine.
d. Support elbows on armrests.
e. Place hand rolls if needed.

Reviewed: 2017