Body mechanics and mobility

BY: -Lemesa A
1 July 2019
 PRACTICE POSITIONING & MOVING A
PATIENT
Body Positioning
Positioning client in various positions is done for
diagnostic and therapeutic purposes.
Some of the reasons include promoting comfort,
restoring body function, preventing deformities,
relieving pressure, preventing muscle strain,
restoring proper respiration and circulation and
giving nursing treatment.

2 May 2019
 Guideline for Positioning the Client
 Maintain client body alignment. (Alignment is similar
whether the client is standing or in bed.)
 Maintain client safety.
 Reassure the client to promote comfort and cooperation.
 Properly handle the client’s body to prevent pain or
injury.
 Follow proper body mechanics.
 Obtain assistance, if needed to move heavy or immobile
clients.
 Follow specific orders.

3 May 2019
 Client Positioning for Examination and
Treatment
1. Horizontal Recumbent/ supine Position: This
position is required for most of the physical
examinations.
 The client lies on the back with the legs extended.
 The arms are placed, folded on the chest, or along the
side the body. One small pillow may be used. Cover
the client with bath blanket for privacy.
Caution: This position may be uncomfortable for a
person with a back problem.

4 May 2019
 Dorsal recumbent position
This position used for variety of examinations and
procedures.
The client lies on the back, with the knees flexed and
the soles of the feet flat on the bed.
Cover the client with a sheet or a bath blanket folded
once across the chest.
The second sheet should be cross wise over the client
thighs and legs. Wrap the lower ends of this sheet
around the client’s legs and feet. Fold the sheet so the
genital area is easily exposed. Keep the client covered
as much as possible.
5 May 2019
 Dorsal recumbent position…

6 May 2019
 Prone Position
Prone position is used to examine the spine and back.
The client lies on the abdomen with head turned to the
side for comfort.
The arms are held above the head or along the side of the
body. Cover the client with a bath blanket for privacy.
Caution: Unconscious clients, pregnant women, clients
with abdominal incisions, and clients with breathing
difficulties cannot lie in this position.

7 May 2019
 Sims’ Position
This position is used for rectal examination.
The client rests on the left side, usually with a small
pillow under the head. The right knee is flexed against
the abdomen, the left knee is flexed slightly, the left arm
is behind the body, and the right arm is in a comfortable
position. Cover the client with a bath blanket.
Caution: The client with leg injuries or arthritis often
cannot assume this position.

8 May 2019
 Fowler’s Position
This position is used to promote drainage or to make
breathing easier.
Adjust the head rest to the desired height, and raise the
bed section under the client’s knees. Place a rolled pillow
between the client’s feet and use the foot of the bed as a
brace, if desired.
Caution: Observe for signs of dizziness or faintness
when you raise the head of the bed.

9 May 2019
 Knee-chest Position
is used for rectal and vaginal examinations.
The client is on the knees with the chest resting on the
bed and the elbow rested on the bed, or with the arms
above the head, the client’s head is turned to the side.
The thighs are straight up and down, and the lower
legs are flat on the bed.
Caution: The client may become dizzy or faint and
fall. Do not leave the client alone.

10 May 2019
 Dorsal Lithotomy Position
is used for examination of pelvic organs. It is similar to
dorsal recumbent position, except that the client’s legs
are well separated and the knees are a cutely flexed.
The nurse will usually place the client’s feet in
stirrups.
Keep the client covered as much as possible for
privacy.

11 May 2019
 APPLY RANGE OF MOTION EXERCISES
Ranges of motion (ROM) exercises are done to preserve
flexibility and mobility of the joints on which they are
performed.
These exercises reduce stiffness and will prevent or at
least slow down the freezing of your joints.
Range of motion is the term that is used to describe the
amount of movement you have at each joint.
Every joint in the body has a "normal" range of motion.
Joints maintain their normal range of motion by being
moved.
It is therefore very important to move all your joints
every day.
12 May 2019
 There are different kinds of ROM exercises.
Active ROM exercises: stretching exercises you can
do yourself when you still have the muscle strength to
move your joints through their complete ranges.
Passive ROM exercises: which are done for weaker
patients by a caregiver.

13 May 2019
 General instructions
Ideally, these exercises should be done once per day.
Do each exercise 10 times or move to the point of
resistance and hold for 30 seconds.
Begin exercises slowly, doing each exercise a few
times only and gradually build up to more.
Move slowly, watching the patient's face for response
to ROM.

14 May 2019
 Lower Extremity Passive ROM Exercises: These
exercises should be done slowly and gently while you
are lying on your back. Each exercise should be done
ten times on each leg each day.
Hip and Knee Flexion: Cradle the leg by placing one
hand on the bent knee. With the other hand, grasp the
heel for stabilization. Lift the knee and bend it toward
the chest. Do not allow the hip to twist during this
movement. The foot should stay in a straight line with
the hip and not swing in or out. The leg is then lowered
to the starting position.
15 May 2019
 Hip Abduction: Cradle the leg by placing your hand under
the knee and holding it. Place the other hand under the heel
to stabilize the hip joint. Keeping the knee straight, move the
leg along the surface of the bed, toward you and away from
the other leg, to approximately 45 degrees. Then bring the
leg back to the other leg.
Ankle Rotation: With the knee straight and one hand
holding the ankle steady, place the other hand around the
foot and turn foot inward, then outward.
Toe Flexion and Extension: With one hand, stabilize the
foot just below the toes. With the other hand, gently move
each or all of the toes forward and backward.

16 May 2019
 HELP PATIENTS WITH CRUTCH WALKING
Crutch Walking
Crutches: - are walking aids made of wood or metal in
the form of a shaft. They reach from the ground to the
client’s axillae.

17 May 2019
 Teaching Techniques of Crutch Walking
A. Four-Point Gait
Equipment
- Properly fitted crutches
- Regular, hard soled street shoes
- Safety belt, if needed
Procedure
1. Explain the rationale for the procedure to the client
a. The gait is rather slow but very stable
b. The gait can be performed when the client can move and bear weight on each leg.
2. Demonstrate the crutch foot sequence to the client.
a. Move the right crutch
b. Move the left foot
c. Move the left crutch
d. Move the right foot
3. Help the client practice the gait. Be ready to help with balance if necessary.
4. Assess client’s progress, and correct mistakes as they occur.
18 May 2019
 A. Four-Point Gait

19 May 2019
 The Equipment is Similar with Four Gait.
B. Three-Point Gait

Procedure
1. Explain the rationale of the procedure
a. The gait can be performed when the client can bear little or no weight
on one leg or when the client has only one leg.
b. This gait is fairly rapid and requires strong appear extremities and
good balance.
2. Demonstrate the crutch-foot sequence to the client.
a. Two crutches support the weaker extremities
b. Balance weight on the crutches
c. Move both crutches and affected leg forward
d. Move unaffected leg forward
3. Assess the client’s progress, and correct any mistakes as they occur.
4. Remain with client until cutch safety is ensured.
20 May 2019
 B. Three-Point Gait

21 May 2019
 C. Two Point-Gait

Procedure
1. Explain the procedure to the client.
a. This procedure is a rapid version of the four point gait
b. This gait requires more balance than the four gait
2. Demonstrate the crutch-foot sequence to the client.
a. Advance the right foot and left crutch simultaneously
b. Advance the left foot and the right crutch simultaneously
3. Help the client practice the gait.
4. Assess the client’s progress, and correct any mistakes as
they occur.

22 May 2019
 C. Two Point-Gait

23 May 2019
 Thank u !!!

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