Positioning

Question 1

blanch

Answer 1

-temporary whitening of the skin that occurs when pressure is applied, indicating that blood has been temporarily pushed out of the area + should return
-quick check of blood flow

Question 2

comatose

Answer 2

-coma, not responding
-prolonged unconsciousness

Question 3

icshemia

Answer 3

lack of blood flow

Question 4

maceration

Answer 4

-the softening + breakdown of skin tissue due to prolonged exposure to moisture
-pressure

Question 5

necrosis

Answer 5

-death of cells or tissue
-due to lack of oxygen

Question 6

max time for position change

Answer 6

minimum of every 2 hours

Question 7

3 reasons we must change positions

Answer 7

-prevent contractures
-relieve pressure/better blood flow
-allows patient to move some extremities more freely

Question 8

what type of contracture is the most common

Answer 8

“flexion” contracture

Question 9

skin inspection- red

Answer 9

indicates areas of pressure

Question 10

skin inspection- paleness

Answer 10

indicates dangerous areas of pressure

Question 11

skin inspection- blanching

Answer 11

indicates dangerous areas of pressure

Question 12

skin inspection- numbness or tingling

Answer 12

indicates excessive pressure

Question 13

skin inspection- localized edema

Answer 13

indicates excessive pressure

Question 14

contracture

Answer 14

-changes in joint structure that limits movement
-changes begin very quickly after immobilization
-NEED MORE THAN 20 MIN OF MOVEMENT PER DAY

Question 15

high risk areas for seated position

Answer 15

-ischial tuberosities
-scapular + vertebral spinous processes
-olecranon processes
-medial epicondyles of humerus if resting on hard surface
-back of knees if resting against seat
-heels + feet

INSTRUCT TO REPOSITION AT 10-15 MIN INTERVALS

Question 16

positioning for supine, long-term

Answer 16

-pillow under head/neck
-scapula/shoulders neutral
-elbows antecubital space upwards
-wrist pronated with towel support (20 degrees extension)
-hips/knees neutral
-ankles have roll above heel (small because too large = knee hyperextension)

Question 17

positioning for supine, short-term

Answer 17

pillow under knees, flexion to 20/30 degrees

Question 18

positioning for prone, short-term

Answer 18

-pillow under abdomen
-towel under anterior ankle
-face hole or folded towel under forehead
-arms in position of comfort

Question 19

positioning for prone, long-term

Answer 19

-think pillow/folded towel under head/neck
-shoulder ER (scapular depression) OR arms at side, shoulders rounded forward, wrist supinated -> towels anterior shoulder “backpack straps”
-NO PILLOW under pelvis/hips (can promote hip flexion contracture)
-small towel roll above malleoli of ankle

Question 20

positioning for sidelying, short-term

Answer 20

-head/neck neutral with pillow
-bottom UE -> scapula protracted, arm in ER
-upper UE -> supported by pillow
-pillow between staggered LE
-towel roll under ankle
-pillow to stabilize back (LONG-TERM ONLY)

Question 21

positioning for sidelying, long-term

Answer 21

-pillow behind patient prevents rolling back
-pillow between legs or legs staggered

Question 22

pushing/pulling is better for body mechanics during positioning

Answer 22

pushing is better than pulling

Question 23

devices/techniques to reduce friction/shearing forces

Answer 23

-mechanical lifts
-trapeze bar
-lift sheet
-transfer boards
-cornstarch

Question 24

purpose of restraints

Answer 24

ex: belts, straps, body garment, bed rails, drugs
-protection of patient or others
-used only when less restrictive interventions don’t work
-physical + drug-induced restraints must be ordered by a physician or orther licensed practitioner responsible for the care of the pt