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?