Component Task: Positions Used in Nursing Patients

A variety of positions are used during physical examination (assessment), surgical interventions and in nursing patients. These positions are also used to promote comfort of the patient or to help the patient relax and to prevent complications.

Common Positions Used

Supine Position

This is where the client lies flat on the back with legs together but slightly flexed at the knees. The head may be supported with a pillow.

Uses 

It is used to examine the head, face, neck, limbs, breast, abdomen and the genitalia.

Contra-Indications

This is not used in patients who have dyspnoea (difficulty in breathing) and also not in patients with burns of the back.

Prone Position

The client lies on the abdomen, flat on the bed, with the head turned to one side.

Uses

It is used to assess the hip joint, posterior thorax, nurse patients with burns at the back, patients with bed sores and decubitus ulcers on the buttocks.

Contra-Indications

This is not used after abdominal surgery, respiratory distress and spinal problems.

Fowlers position (Upright)

Patient is placed in the sitting position and is supported with pillows and back rest. Client is placed in about 80-90 degrees.

Please note that Semi - fowlers is when the patient is placed in about 30-40 degrees.

Uses

Patients with chronic heart disease who have dyspnea, chest and heart surgeries. It is also used in draining abdominal cavity.

Contra-Indications

This position is not used in patients who has just had spinal and brain surgery. It cannot be used in hypotensive clients.

Dorsal Position

Patient lies on the back with one pillow under the head, legs separated and knee bent with the sole of the feet on the bed.

Uses

For abdominal and vaginal examination. Also for patients who have difficulty maintaining the supine position but needs abdominal examination.

Contra-Indications

Not used in patients with burns of the back and fractures of the lower limbs.

Sim’s Position

The patient lies on either the right or left side and the lower arm behind the body with the upper arm flexed at the elbow, knees flexed with uppermost leg more acutely flexed.

Uses

Used in rectal, vaginal or perineal examination. Also used in giving enema, suppositories, and then passing of flatus tube.

Contra-Indication

Cannot be used in client who had just had hip replacement surgery and other orthopedic surgeries.

Lithotomy Position

With this position, the patient lies supine with the buttocks at the edge of the examination table and both legs supported in stirrups.

Uses

Evacuation or evaluation of the uterus. It is also used in rectal and vaginal examination. Also used in gynecological examination and in labor ward delivery.

Contra-indication

Should not be used in clients with joint deformity or strictures.

Trendelenburg’s Position

The patient lies in supine position with the head side of the bed brought 30-40 degrees lower than the feet.

Uses

It is used in treating shock, hypotension and in pelvic examination.

Contra-Indication

Should not be used in head injuries, spinal injuries, unconscious patient etc.