Positioning Clients
Semi-Fowler’s
Head of bed elevated to 30°
Gastric feedings, head injury, postoperative cranial surgery, respiratory illness with dyspnea, postoperative cataract removal, increased intracranial pressure
Fowler’s
Head of bed elevated to 45°
Head injury, postoperative cranial surgery, postoperative abdominal surgery, respiratory illness with dyspnea, cardiac problems with dyspnea, bleeding esophageal varices, postoperative thyroidectomy, postoperative cataract removal, increased intracranial pressure
High Fowler’s
Head of bed elevated to 90°
Respiratory illness with dyspnea: emphysema, status asthmaticus, pneumothorax, cardiac problems with dyspnea, feeding, meal times, hiatal hernia, during and after meals
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Supine (dorsal recumbent)
Lying on back, head, and shoulders; slightly elevated with a small pillow
Spinal cord injury (no pillow), urinary catheterization
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Prone
Lying on abdomen, legs extended, and head turned to the side
Client who is immobilized or unconscious, post lumbar puncture 6 to 12 hr, post myelogram 12 to 24 hr (oil based dye), postoperative tonsillectomy and adenoidectomy
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Lateral (side laying)
Lying on side with most of the body weight borne by the lateral aspect of the lower ilium
Post abdominal surgery, client who is unconscious, seizures (head to side), postoperative tonsillectomy and adenoidectomy, postoperative pyloric stenosis of the lower scapula and the lateral (right side), post liver biopsy (right side), rectal irrigations
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Sims’ (semi-prone)
Lying on the left side with most of the body weight borne by the anterior aspect of the ilium, humerus, and clavicle
Client who is unconscious, enemas
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Lithotomy
Lying on the back with hips and knees flexed at right angles and feet in stirrups
Perineal procedures, rectal procedures, vaginal procedures
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Trendelenburg
Head and body lowered while feet are elevated
Shock
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Modified Trendelenburg
Supine with legs elevated
Prevent shock
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Reverse Trendelenburg
Head elevated while feet are lowered
Cervical traction; also used to feed clients restricted to supine position, such as postcardiac catheterization
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Elevate one or more extremities
Elevate legs/feet or arms/hands by adjusting or supporting with pillows
Thrombophlebitis, application of cast, edema, postoperative surgical procedure on extremity