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by: Hannah James
Hannah James
GPA 3.95

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This 4 page Class Notes was uploaded by Hannah James on Monday September 12, 2016. The Class Notes belongs to at University of North Alabama taught by in Fall 2016. Since its upload, it has received 3 views.


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Date Created: 09/12/16
Clinical Objectives – Mobility 1. To aid patients in assuming good body alignment, the nurse needs  to ensure that no excessive strain is placed on the patient’s joints,  tendons, ligaments, or muscles. This may be done by helping  patient to assume a supine or fowler’s position in bed for example. 2. To move a patient from bed to chair, you must first raise bed to  waist level, place feet a good width apart and place arm nearer  head of bed under patient’s shoulders. Raise patient to sitting  position by shifting weight from fornt to back leg, Help patient to a sitting position on the side of the bed and bring chair to 45 degree  angel on patient’s strongest side. Apply transfer belt if necessary  and then spread feet apart, flex hips and knees – aligning knees  with patient’s knees then grasp transfer belt from underneath along patient’s sides. Rock patient up to standing position on count of 3  while straightening hips and legs and keeping knees slightly  flexed. Pivot on foot farther from chair and instruct patient to use  armrests on chari for support and ease into chair. Flex hips and  knees while lowering patient into chair. For moving a patient from  a chair to the bed, you would perform the same actions as getting  them out of bed and pivot them towards the bed then flex hips and  knees as you lower them into the bed. Then aid them in assuming a supine position – then lower the bed to a safe height.  For Transferring a patient to a stretcher from the bed – raise the  bed to height of stretcher, lower head of bed as much as patient can tolerate, cross patients arms on chest. Lower side rails and have  two aregivers stand on side where stretcher will be. Help patient  roll onto side and place slide board underneath patient. Align  stretcher alongside of bed and lock wheels once in place. Have all  three caregivers stand at a wide stance and on count of three have  caregivers move draw sheet or patient from bed onto stretcher then put the side rails of stretcher up. To move the patient from a  stretcher to a bed the same steps are followed.  3. For patients on bed rest several positions can be used to provide  comfort and prevent skin breakdown: a.  Supported Fowler’s position – head of bed elevated to 45  degrees and patients knees slightly elvated without pressure  to restrict circulation b. Supine position – bed flat and patient on back c. Prone position – bed flat and patient lies face or chest down  with head turned to side d. Side­Lying position – bed flat, patient on side at a 30 degree  lateral poisition. e. Sim’s position – bed flat, patient on side with weight on the  anterior ileum, humerus, and clavicle 4. There are many range of motion exercises, but several key ones  are: a. Flexion of neck – bringing chin to rest on chest b. Extension of neck – retrun head to erect position c. Flexion of shoulder – raise arm from side to above head d. Extension of shoulder – lower arm to side of body e. Flexion of elbow – bend elbow so lower arm moves toward  shoulder joing  f. Extension of elbow – straighten elbow by lowering  hand g. Flexion of fingers – make fist h. Extension of fingers – straighten fingers i. Flexion of hip – move leg forward and up j. Extension of hip – move back beside other leg k. Flexion of Knee – bring heel back toward back of thigh l. Extension of knee – return leg to floor 5. When using a trochanter roll, the nurse is responsible for placing  the folded blankets (trochanter roll) underneath the patient’s  buttocks and rolling it counterclockwise until the thigh is in a  neutral position or inward rotation.  a. When using a footboard a nurse simply places the footboard  at the end of the bed and encourages the patient to use it to  reposition in bed b. Elastic stockings and sequential compression devices can be  delegated by the nurse or the nurse can apply both by turning  the stocking inside out and rolling it onto the patients leg  starting at the toes and working upward and then placing the  SCD cuff snugly around patient’s calfs and then plugging  them into the pump. 


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