FON Ch.18 Lifting, Moving, Positioning

Ulcer formation over the the sacral area.

A nurse places the patient in Fowler position for an entire 8-hour shift. Which complication may occur due to extended Fowler positioning?

The head is centered and erect, Knees and ankles are slightly flexed, arms are hanging comfortably by the patient's sides.

A nursing student assists a patient into a chair. Which posture indicates the patient has correct body alignment? Select all that apply.

Circumduction of the wrist joint

A paraplegic patient is at risk of developing contractures of the wrist joints. Which exercise should the nurse teach the patient to prevent the development of contractures?

Turn the patient's head toward the right and then left shoulder, bend the patient's head toward the right and then left shoulder, Bring the patient's head forward until the chin touches the chest.

A patient is bedridden following a stroke. Which interventions does the nurse perform to increase mobility of the cervical spine? Select all that apply.

Raise the bed to the level of the stretcher, cross the patient's arms on chest while transferring, involve multiple caregivers for safe transfer.

A patient is being transferred from the bed to a stretcher. What precautions should the nurse take to ensure patient safety during transfer? Select all that apply.

Maintain arms parallel to the body, place a pillow under the pronated forearms

A patient is lying in a supine position. How does the nurse prevent internal rotation of the shoulder? Select all that apply.

maintain arms parallel to the body, place a pillow under the pronated forearms.

A patient is lying in a supine position. How does the nurse prevent internal rotation of the shoulder? Select all that apply.

Place a pillow between the chest and upper arm.

A patient is placed in Sims position. What nursing intervention will be helpful in preventing internal rotation and adduction of the shoulder?

Legs are spread apart, Feet are placed in stirrups, Patient lies on his back.

A patient is placed in a dorsal lithotomy position in preparation for a pelvic examination. Which is a correct description of dorsal lithotomy positioning? Select all that apply.

Roll the pillow against the patient's back, place a pillow lengthwise between the patient's flexed knees, tuck a pillow folded lengthwise under the patient.

A patient needs to be placed in a side-lying position; however, the patient frequently rolls back to his original position and loses alignment. How does the nurse secure this patient and reduce the pressure ulcers? Select all that apply.

Fowler position

A patient wants to watch television. The television is at the foot of the bed, mounted high on the wall facing the patient. In which position should the nurse place the patient to promote the patient's comfort while watching television?

Pathological fractures

A patient who has attained menopause is diagnosed with osteoporosis. What consequences of osteoporosis should the nurse observe in the patient?

Footdrop

A patient who has hemiplegia is unable to dorsiflex and invert the feet. Which condition does the patient likely have?

the nurse first performs hand hygiene to prevent the transfer of microorganisms to the patient. The wheelchair should be placed parallel to the bed and locked, so that it does not move while shifting the patient. To decrease work and promote patient safety, the head of the bed should be elevated to the highest acceptable level. To provide privacy for the patient, the nurse should help the patient in donning the robe. In order to allow the patient to sit down without twisting in the chair, it must be pivoted 90 degrees so that patient's back is towards the chair.

The nurse assists in transferring the patient from the bed to a wheelchair. The nurse ensures that the bed's wheels and the wheelchair are locked for patient safety. What is the correct sequence of events that the nurse must follow to shift the patient to a wheelchair?

Every hour.

The nurse is caring for a dehydrated, debilitated, and bedridden patient. How frequently should the nurse turn and reposition the patient?

Placing a small towel roll under the patient's thighs, elevating the head of the bed from 30 to 90 degrees

The nurse is caring for a patient who had a stroke. Which interventions will help to comfortably position the patient? Select all that apply.

Reposition the patient every one to two hours, place the patient in a 30-degree lateral position, avoid pulling the patient when repositioning, keep the patient well hydrated.

The nurse is caring for a patient who is immobilized due to a stroke. What measures should the nurse take to prevent development of pressure ulcers in the patient? Select all that apply.

A 20-year-old unconscious patient, A 90-year-old frail patient, a 40-year-old patient who has paraplegia.

The nurse is caring for patients on a medical-surgical unit. The nurse plans the patients' care and instructs the nursing assistant to assist in repositioning patients every 2 hours. Which patients are at the greatest risk for complications if not repositioned properly? Select all that apply.

The knees are bend, with the lower legs flat on the bed, the patient's thighs are perpendicular to bed, the chest,elbows and knees are on bed.

The nurse is helping a patient achieve a knee-chest position for rectal examination. How is the patient placed in a knee-chest position? Select all that apply.

Placing a small pillow under the thighs.

The nurse is helping to position a patient. Which nursing intervention prevents the occlusion of the patient's popliteal artery?

Watch patient's face for discomfort.

The nurse is performing a passive range-of-motion exercise for a bedridden patient. How does the nurse know that the joints are stretched beyond the comfort of the patient?

Asks the patient to flex the knees, positions the patient's feetflat on the bed, tells the patient to lie on the back, Places a footboard at the bottom of the bed,

The nurse is placing a patient in a dorsal recumbent position. What actions does the nurse perform?Select all that apply.

"You should avoid sudden pulling motions when assisting a patient from the chair back to bed." "Do not twist your body trunk while lifting and/or pulling patients up in bed." "Be sure to face the object you intend to move. If you are putting supplies onto shelves, face the objects you are moving."

The nurse is teaching a nursing student about body mechanics. What recommendations should the nurse give to the nursing student with regards to moving and lifting objects? Select all that apply.

Dorsiflexion of the foot, plantar flexion of the foot, circumduction of the ankle.

The nurse is teaching range-of-motion exercises to a patient who is immobilized due to orthopedic surgery. Which exercises help in preventing the development of foot drop? Select all that apply.

Maintain the patient's foot in dorsiflexion.

What action should the nurse take to prevent the development of foot drop in a bedridden patient who remains in a supine position most of the time?

Support the lateral aspect of the thigh with a sand bag.

Which intervention does the nurse perform to prevent external rotation of the hips in the patient placed in a supine position?

Roll the lift sheet close to the patient's body.

Which is the proper technique when performing a transfer with a lift sheet?

Support the flexed arm and leg with a pillow.

Which nursing intervention is helpful in promoting chest expansion in the patient placed in Sims position?

When supine, the vertebral column should be in alignment.

Which statement describes proper body alignment of a patient?

Elevate the head of bed to 40 degrees.

How does the nurse place a patient in semi-Fowler position?

Dorsiflexion

How does the nurse position the feet of the patient who is in a prone position?

Place a pillow under the patient's abdomen below the diaphragm.

How does the nurse prevent hyperextension of the lumbar vertebrae in the patient placed in a prone position?

Repositioning may provide comfort to the patient, repositioning relieves constant pressure on body parts, repositioning may prevent deformities and respiratory problems.

The nurse asks the patient's caregiver to frequently change the patient's position, as the patient is bedridden. What could be the possible reasons behind the nurse's instruction? Select all that apply.

Sims position

A patient arrives at the clinic with complaints of chronic constipation. The primary health care provider recommends the patient undergo a rectal examination. The nurse places the patient in which position in preparation for a rectal examination?

Elevate and depress the shoulder, as if shrugging.

A patient develops a stiff shoulder following a sports injury. Which exercise should the nurse teach the patient to help loosen and relax the shoulder joint?

Performing internal rotation of the shoulders, performing external rotation of the shoulders, raising and lowering the arms above the head.

A patient has sustained an injury to the shoulders. Which exercises does the nurse teach the patient to help promote joint movements and exercise the shoulder muscles? Select all that apply.

Keep trunk erect and bend the knees.

Health care professionals have an increased risk of musculoskeletal injuries because their occupation involves lifting and transferring patients. How can the nurse reduce the risk of musculoskeletal injuries when lifting any person or object?

The abdomen muscles are pulled inwards.

The job of the nurse is physically demanding. To prevent injury to the muscles and bones, the nurse assumes good posture. Which statement correctly illustrates good posture?

Move the patient's shoulder blade forward against the bed

The nurse assists the patient into a side-lying oblique position. What measure does the nurse take to evenly disperse the patient's weight and prevent the patient's weight from centering on his shoulders?

Move the patient's shoulder blade forward against the bed.

The nurse assists the patient into a side-lying oblique position. What measure does the nurse take to evenly disperse the patient's weight and prevent the patient's weight from centering on his shoulders?

The nurse should check the pulses in the lower limbs.

The nurse has placed a patient in Fowler position. The nurse understands that in this position, the popliteal artery may become obstructed. How would the nurse assess the patency of the popliteal artery?

Trochanter

The nurse is caring for a bedridden patient in the side-lying position. Which pressure point does the nurse assess for pressure effects?

Stretch the muscles to keep the joints flexible, provide support to limbs on either side of the joints, do not stretch the muscles beyond the point of discomfort.

The nurse is performing therapeutic exercises for a bedridden patient. What principles must the nurse follow while performing range-of-motion exercises? Select all that apply.

Knees should be flexed, feet should be flat on the bed, patient should lie on the back.

The nurse needs to place a patient in a dorsal recumbent position for examination. How is the patient correctly placed for this position? Select all that apply.

Joint motion may decrease.

The nurse understands that which changes occur with aging?

Elevate the patient's head of bed to 70 degrees.

The primary health care provider writes an order to place the patient in Fowler position. How does the nurse implement this order?

Lateral flexion of the neck

When a patient is in the side-lying position, which posture should be avoided?

Using cushioned boots or splints.

While positioning a severely injured patient, which nursing intervention will help prevent heel pressure?

elderly patients

The nurse knows that elevation of the knees above 15 degrees in the supine position is contraindicated in:

lower back strain

The nurse knows that one of the most common injuries for health care workers is:

Prone

The nurse knows that which position is when the patient is lying face down?

Cramps and contractures, risk of fluid collection in the lungs, risk of development of pressure ulcers.

The nurse observes that the positioning and alignment of a patient is improper. How should the nurse educate the caregiver regarding possible complications due to improper positioning? Select all that apply.

Place pillow under patient's lumbar spine.

The nurse understands that a bedridden patient in a supine position may develop back pain if not positioned correctly. How can the nurse prevent back pain in this patient?

capillary fragility

The nurse understands that the elderly have a greater risk of skin breakdown because they have:

Patients are on their back with knees flexed and soles of feet flat on the bed.

The nurse understands that which statement describes the dorsal recumbent position?

To prevent external rotation of hips and legs.

The nurse uses sandbags to help position a patient. What could be the reason behind this intervention?