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Body Mechanics, Turning, Positioning and ROM

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

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Body Mechanics, Turning, Positioning and ROM

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  1. Body Mechanics, Turning, Positioning and ROM Teresa, V. Hurley, MSN, RN

  2. Body Mechanics What is body mechanics?

  3. 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

  4. Effects of Immobility on the Body • Musculoskeletal • Respiratory • Circulatory • Gastrointestinal • Urinary • What other areas are effected?

  5. 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

  6. Positions • Supine [dorsal recumbent] • Prone • Sims [semi-prone] • Fowlers [low, semi and high] • Lateral • Trendlenberg [shock

  7. 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?

  8. Positioning Clients • Turn and position q 2 hours (prevent nerve, small vessel, muscular, skin impairments

  9. Positioning Devices • Maintain body alignment • Prevent contractures • Promote comfort Types of Devices -Can you name at least 5 devices?

  10. 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

  11. 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

  12. 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

  13. 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

  14. Special Considerations • Obtain MD order for ROM for clients with • Arthritis • Fractures • Joint dislocations • Torn ligaments • Acute MI • Bone tumors or metastases

  15. Special Considerations • Elderly -avoid neck hyperextension -limit attempts at full ROM

  16. ROM Exercises • Extension • Flexion • Circumduction • Abduction • Adduction • Internal Rotation • External Rotation • Pronation • Supination • Eversion • Inversion • Opposition

  17. 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

  18. Unexpected Situations • Client c/o of tiredness • Client c/o of sharp, sudden pain while exercising left leg • What will you do?

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