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PTH 121 Positioning and Draping
Terms in this set (36)
What are the rationales for Proper Positing?
1. Prevent soft tissue injury 2. Provide patient comfort 3. Provide support and stability of the body 4. Provide access and exposure to areas to be treated 5. Promote efficient function of patient's body system 6. Relieve excessive, prolonged pressure to soft tissue, bony prominences, and circulatory and neurological structures.
Guidelines for Positioning and Draping: Refer to your Patient Treatment Guideline?
1. Introduce yourself 2. Tell the patient what you are going to do - position them for treatment 3. Tell them what specific articles of clothing you want them to remove 4. Provide them with a gown/drape for modesty 5. Have them remove valuables and have them place them in their purse/pocket 6. Assist them as needed at the conclusion of the treatment
Describe the Prone Position?
Prone lie face down
What are the comfort positions for Prone?
roll towel for forehead, to avoid lower back pain, place pillow under stomach -decreases lumbar lordosis
When should you not place a pillow underneath the stomach during prone?
If patient has a fractured vertebrae
What are the areas of greatest pressure (note: capitalized were red in notes)?
FOREHEAD; lateral ear, tip of acromion process, PETELLA, DORSUM OF FEET, RIDGE OF TIBIA.
WHAT ARE THE AREAS OF COMMON SOFT TISSUE CONTRACTURE SITES (note: capitalized were red in notes)?
ankle planter flexors; shoulder extensors, adductors as well as internal/external rotators; neck rotators
Describe the supine position?
Lie face up/lie on back
What is the semi fowler's position?
head at 45-60°, knees straight/bent with pillow support - NOT SEEN AS MUCH ANY MORE
Comfort procedures for supine?
pillow under head; pillow under knees to release pressure from the pelvis on the lower back; small rolled towel or small bolster under ankles to relieve pressure on calcaneus
What is the area of greatest pressure in supine position (CAPS ?
occipital tuberosity, spine/inferior angle of scapula, spinous process of vertebrae, posterior iliac crests, SACRUM, POSTERIOR CALCANEUS. If lower extremities in excessive external rotation - lateral malleolus
What are the AREAS OF COMMON SOFT TISSUE CONTRACTURE SITES?
hip & knee flexors; ankle plantar flexors; shld extensors, adductors and internal rotators; hip external rotators
Side lying position can be?
Left or Right
Comfort procedures for Side-lying position?
place pillow under the head; with knees bent, place pillow between knees to keep upper leg and hip parallel-reduces the pull on the low back area / hips and knees flexed; provide a pillow to hug - this supports the upper shoulder
Areas of greatest pressure for side-lying position (CAPS in red)?
LATERAL EAR, lateral ribs, LATERAL ACROMION PROCESS, GREATER TROCHANTER, LATERAL AND MEDIAL CONDYLES OF FEMUR, MALLEOLUS OF FIBULA/TIBIA
Areas of common soft tissue contracture sites for side lying position?
hip & knee flexors, hip adductors and internal rotators; shoulder adductors and internal rotators
Explain the position sitting?
with the head of the table raised for back support or sit in a chair (preferably with arm rests)
Comfort procedures for sitting?
Position the chair against wall, table,
What type of chair should you never position your patient while sitting?
Never a Rolling stool
How should your feet be positioned while sitting?
Flat on the floor
Areas of greatest pressure when sitting ?
ISCHIAL TUBEROSITIES (butt bones), posterior thighs, SACRUM
Areas of common soft tissue contracture sites for sitting?
Hip and knee flexors, hip abductors, and internal rotators; should adductors, extensors and internal rotators.
What does preventative positions mean?
Positions to avoid
What is a Transfemoral Amputation?
above the knee amputation
For Transfemoral amputation what position should you avoid putting them in?
prolonged hip flexion (don't elevate the residual limb in supine) - 40 mins./hr max in sitting; hip abduction.
What is the recommended position for Transfemoral amputation?
Recommended position - prone with residual limb in neutral alignment
What is a transtibial amputation?
Below the knee amputation
Position to stay away form with Transtibial Amputation?
prolonged hip & knee flexion (minimal flexion in supine-keep knee extended;
Recommended position for transtibial amputation?
prone position to increase extension
What is hemiplegia?
Paralysis of one side of the body
Position to stay away from for UE for a pt with Hemiplegia?
prolonged shld adduction & internal rotation; elbow flexion; forearm supination or pronation; finger/thumb adduction; support weight of arm to prevent subluxation
What is rheumatoid arthritis?
immune system attacks the joints.
Position to stay away from with a pt suffering from Rheumatoid arthritis?
Prolonged immobilization; joint flexion
Positions to stay away from Burns/Grafted Burns?
: prolonged positioning; prolonged flexion/adduction of peripheral joints; positions of comfort
What is the Rationale for draping?
1. Provide modesty for the patient. 2. Maintain appropriate body temperature during treatment. 3. Provide access and exposure to areas to be treated while protecting other areas. 4. Protect the patient's skin/clothing from being soiled or damaged.
Proper procedure while draping a Pt?
1. Provide gown or shorts to patients in order to access the desired body part. 2. Place sheet on plinth/table for the patient to lie upon. Provide a sheet to cover the patient for modesty and warmth during a treatment. 3. When transporting patients in a wheelchair, ensure that they are not exposed from the back and the drape is securely fastened to prevent unnecessary body exposure. May use a second gown as a "bathrobe" to ensure total coverage. 4. When performing exercises, use draping to cover body areas not being treated if exposure may occur. i.e.: doing PROM on a lower extremity for a patient in the ICU
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