o INCREASES MUSCLE STRENGTH
o MAINTAINS BODY FLEXIBILITY
o IMPROVES RESPIRATORY FUNCTION
o PREVENTS POOLING OF FLUID IN THE LUNGS
o IMPROVES CIRCULATION
o HELPS MAINTAIN HEALTHY SKIN
o PROMOTES EFFECTIVE ELIMINATION
o AIDS DIGESTION
o RELIEVES STRESS
EVERY BODY SYSTEM IS AFFECTED
CONTRACTURE
AN ABNORMAL SHORTENING OF THE MUSCLE DUE TO LACK OF USE.
THE MUSCLE IS FIXED INTO POSITION, IS DEFORMED, AND CANNOT STRETCH.
THE PERSON WITH A CONTRACTURE IS PERMANENTLY DISABLED
ATROPHY
ATROPHY – A DECREASE IN SIZE OR A WASTING AWAY OF MUSCLE TISSUE.
CAUSED BY LACK OF USE
DECUBITUS ULCER
A BREAKDOWN IN SKIN TISSUE THAT OCCURS WHEN BLOODFLOW TO AN AREA IS INTERRUPTED
MORE DECUBITI
THE TRUNK OF THE PERSON SHOULD BE IN A STRAIGHT LINE WHEN THE PATIENT IS LYING DOWN
THE PATIENT IN A CHAIR SHOULD SIT UP STRAIGHT
HIS FEET SHOULD EITHER
REST ON THE FLOOR OR ON A
STOOL
HIS LOWER BACK SHOULD REST AGAINST THE BACK OF THE
CHAIR
THE BACKS OF HIS KNEES SHOULD BE SLIGHTLY AWAY
FROM THE SEAT OF THE CHAIR
PROPER POSITIONING IN A CHAIR
DESIGNED TO HELP THE PATIENT MAINTAIN CORRECT BODY ALIGNMENT AND PREVENT COMPLICATIONS
BED CRADLE
KEEPS THE WEIGHT OF THE LINENS FROM PRESSING ON THE PATIENT’S BODY
FOOT BOARD
KEEP THE FOOT IN A NATURAL POSITION TO PREVENT FOOT DROP (PLANTER FLEXION)
FOOT DROP BOOT
HELPS PREVENT FOOTDROP
HAND ROLL
PERMITS THE HAND TO FLEX SLIGHTLY AND PREVENTS CONTRACTURES OF THE FINGERS
o IF THE PATIENT IS UNABLE TO CHANGE POSITION INDEPENDENTLY , YOU WILL NEED TO ASSIST .
o PATIENTS NEED TO BE TURNED EVERY TWO HOURS.
Lateral position
• Fowler’s position is a semi‑sitting position.– The spine is kept straight.– The head is supported with a small pillow.– The arms are supported with pillows.
• The supine (dorsal recumbent) position is the back‑lying position.– The bed is flat.– The head and shoulders are supported on a pillow.– Arms and hands are at the sides.
• Prone position– The person lies on the abdomen with the head
turned to one side.– The bed is flat.– Small pillows are placed under the head, abdomen,
and lower legs.– Arms are flexed at the elbows with the hands near
the head.
• Lateral position (side-lying)– A pillow is under the head and neck.– The upper leg, ankle, and thigh are supported with
pillows.– A pillow is positioned against the person’s back.– A small pillow is under the upper arm and hand.
ORTHOPNEIC POSITION
FREQUENTLY USED BY PATIENTS WITH RESPIRATORY PROBLEMS
HELPS EXPAND THE CHEST AND LUNGS TO ALLOW MORE OXYGEN TO ENTER
MOVING PERSONS IN BED
• Protect the skin when moving the person.– Friction is the rubbing of one surface against
another.– Shearing is when the skin sticks to a surface while
muscles slide in the direction the body is moving.
• To reduce friction and shearing:– Roll the person or use assist devices.– Use a lift sheet (turning sheet), turning pad, large
incontinence product, slide board, or slide sheet.
THE SKIN STICKS TO THE SURFACE BUT THE
INTERNAL STRUCTURES ( BONE AND MUSCLE )
SLIDE IN THE DIRECTION THE BODY
IS MOVING
OCCURS WHEN THE PATIENT SLIDES DOWN
IN BED
IF THE PATIENT CAN ASSIST:
HAVE THE PATIENT GRASP THE
HEADBOARD AND BEND HIS KNEES
PLACE YOUR FOREARMS UNDER HIS
SHOULDERS AND KNEES
LIFT AT THE COUNT OF THREE
IF THE PATIENT HAS A TRAPEZE ON THE BED
HAVE THE PATIENT GRASP THE TRAPEZE AND BEND
AT THE KNEES
MOVING UP IN BED
A LIFT SHEET MAKES LIFTING EASIER
HELPS PREVENT FRICTION AGAINST
THE PATIENT’S SKIN
TAKES TWO WORKERS TO LIFT
IF PATIENT CAN HELP HAVE HIM BEND HIS
KNEES
USE FOR PERSONS WHO CAN NOT HELP
WITH THE MOVE
THE PERSON IS MOVED IN SEGMENTS
PROPER POSITIONING FOR LATERAL POSITION
A PATIENT WHO HAS A SPINAL INJURY OR SPINAL SURGERY MUST BE KEPT IN GOOD BODY ALIGNMENT WHEN TURNING.
USING A LIFT SHEET THE PERSON IS TURNED IN ONE MOTION.
IT TAKES 2 OR 3 PERSONS TO SAFELY LOGROLL A PATIENT.
DANGLING REFERS TO SITTING ON THE SIDE OF THE BED WITH THE FEET HANGING DOWN
DO NOT LEAVE THE PATIENT ALONE WHEN DANGLING.
HAVE THE PATIENT COUGH, DEEP BREATHE, AND EXERCISE THEIR LEG MUSCLES WHEN DANGLING.
IF THE PATIENT BECOMES DIZZY LIE HIM DOWN.
CHECK THE PERSON’S PULSE AND RESPIRATIONS
• DO NOT ALLOW THE PERSON TO PUT HIS ARMS AROUND YOUR NECK• MAKE SURE YOU LOCK THE WHEELS ON THE BED AND WHEELCHAIR
o APPLY THE BELT AROUND THE PERSON’S WAIST, OVER THE CLOTHING.
o TIGHTEN THE BELT SO IT IS SNUG. IT SHOULD NOT CAUSE DISCOMFORT OR IMPAIR BREATHING. YOU SHOULD BE ABLE TO SLIDE YOUR OPEN HAND UNDER THE BELT.
o PLACE THE BUCKLE SLIGHTLY OFF CENTER IN THE FRONT.
o DO NOT USE WITH PATIENTS WITH FRACTURED RIBS, ABDOMINAL SURGERY, OR HAVING BREATHING DIFFICULTIES
NOTE THE POSITION OF THE CNA’S HANDS ON THE GAIT BELT
NOTE HIS USE OF PROPER BODY MECHANICS
NOTE THE PLACEMENT OF HIS KNEES AGAINST THE KNEES OF THE PATIENT
ALSO CALLED
HOYER LIFT
USED TO TRANSFER PATIENTS WHO ARE
PARALYZED, VERY HEAVY, OR DIFFICULT TO MOVE
YOU NEED AT LEAST 2 STAFF MEMBERS TO
SAFELY USE A MECHANICAL LIFT
MANY FACILITIES HAVE “NO LIFT” POLICIES.
A SPECIAL LIFT IS USED TO STAND AND MOVE RESIDENTS IF YOUR FACILITY HAS THIS RESTRICTION.
PARALYZED PERSONS USE A TRANSFER BOARD FOR TRANSFER FROM
WHEELCHAIR TO BED
THE WHEELCHAIR IS
PLACED AT A RIGHT ANGLE
TO THE TOLIET
TAKES 4 OR MORE STAFF
USE A LIFT SHEET OR SLED TO PULL PATIENT OVER ONTO CART
REPOSITIONING A RESIDENT IN A WHEELCHAIR
o LOCK THE WHEELS AND MOVE THE FOOTRESTS OUT OF THE WAY
o DO NOT PULL THE RESIDENT UP BY THE ARMS
o TO AVOID INJURY TO THE RESIDENT USE TWO STAFF MEMBERS
o ALWAYS LOCK THE BRAKES WHEN TRANSFERRING
o CLEAN THE WHEELCHAIR ON A REGULAR BASIS
o MOVE THE FOOTRESTS OUT OF THE WAY WHEN TRANSFERRING
CARDIAC CHAIR GERI-CHAIR
BACK DOWN A RAMP WITH A WHEELCHAIR
BACK INTO THE ELEVATOR SO THE
PATIENT FACES THE FRONT
TRANSFER THE PATIENT FEET FIRST DOWN A RAMP
ENTER THE ELEVATOR HEAD FIRST