Body Mechanics, Turning, Positioning and ROM

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Nov 2, 2013 (3 years and 5 months ago)

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Body Mechanics, Turning,
Positioning and ROM

Teresa, V. Hurley, MSN, RN

Body Mechanics



What is body mechanics?

Body Mechanic Principles



Center of gravity


Line of gravity


Base of support


Body alignment


Balance


Coordinated Movements


Assess before acting


Slide, roll, push, or pull rather than lift


Assistance




Effects of Immobility on the Body


Musculoskeletal


Respiratory


Circulatory


Gastrointestinal


Urinary



What other areas are effected?



Turning a Client



Place arms across chest


Cross one leg over the other leg


Tighten your gluteal and abdominal muscles, flex
knees and use leg muscles to do pulling


Roll client toward you after you placed one hand
on far shoulder and the other on the hip


Support back with pillow/blanket


Pull shoulder blade forward

Positions


Supine [dorsal recumbent]


Prone


Sims [semi
-
prone]


Fowlers [low, semi and high]


Lateral


Trendlenberg [shock


Which of the positions are
contraindicated for:


cervical or lumbar problems?


cardiac or respiratory difficulty?


Which position used for clients with SOB?


Which position used for enema?



Positioning Clients


Turn and position q 2 hours


(prevent nerve, small vessel, muscular, skin
impairments










Positioning Devices


Maintain body alignment


Prevent contractures


Promote comfort


Types of Devices


-
Can you name at least 5 devices?

Types of Devices


Pillows, blankets, towels, wash cloths, foam
wedges


Side rails


Trapeze bar


Sandbags


Trochanter rolls


Foot board


Bed cradle or foot cradle


High top sneakers


Moving Up in Bed


Check for restrictions


Equipment attached to client moves with them


Assess size of client and their ability to assist


Medicate with analgesics


Lock wheels


Avoid friction


Use safety and lifting devices



Moving Client up in Bed



Place pillow against the head board


Client bend knees with feet flat on bed if able


Arms across chest


Lift head with chin on chest


Stand at mid
-
section


Spread feet shoulder length with one foot slightly
in front of other


Flex knees and hips


Range of Motion


Active Range of Motion (AROM)


Passive Range of Motion (PROM)



Support areas proximal and distal to the
joint


Repeat exercises 2 to 5 times


Stop if c/o pain or if resistance met






Special Considerations


Obtain MD order for ROM for clients with


Arthritis


Fractures


Joint dislocations


Torn ligaments


Acute MI


Bone tumors or metastases


Special Considerations


Elderly



-
avoid neck hyperextension



-
limit attempts at full ROM

ROM Exercises


Extension


Flexion


Circumduction


Abduction


Adduction


Internal Rotation


External Rotation


Pronation


Supination


Eversion


Inversion


Opposition

Documentation

10/3/2006 9:30 am Client performed AROM
of head, neck, shoulders, arms, wrist and
fingers. PROM to lower extremities
performed by husband accurately. Denied
c/o pain during exercises. Sitting in semi
-
fowlers position, one side rail up, call light
in reach, watching DVD movie with
husband.
R. Powell, RN

Unexpected Situations


Client c/o of tiredness


Client c/o of sharp, sudden pain while
exercising left leg



What will you do?