THERAPEUTIC POSITIONS

1. POSITION'S

2. DEFINITION
Positioning is defined as planning the person in a
proper body alignment for
preventive, promotive, curative
the purpose of
and rehabilitative
aspects of health or placing the patient in good body
alignment as needed therapeutically.

3. PURPOSES
⯈To promote comfort to the patient
⯈To relieve pressure on various parts
⯈To stimulate circulation
⯈To provide proper body alignment
⯈To carry out nursing intervention
⯈To perform surgical and medical interventions
⯈To prevent complications caused by immobility
⯈To promote normal physiological functions

4. PRINCIPLES
⯈Maintain good body mechanics
⯈Wash hands before and after procedure
⯈Ensure patient’s comfort
⯈Obtain assistance as required
⯈Ensure that mattress is firm and level of bed is at
working hide
⯈Follow safety measures to prevent accidents
⯈Follow the systematic and orderly way of doing
⯈Use right technique at right time

6. 1. SUPINE POSITION
⯈The patient lies on his back with his head and
shoulders are slightly elevated
Indication
⯈Usual position
⯈Examination of the chest and abdomen

7. PROCEDURE
⯈Place the patient on back with one pillow under
the head, arms and hands at the sides, knees
flexed and separated.
⯈Place the air ring under the hips and cotton or
foam pads under the heels to reduce the pressure.
⯈Place footboard under bottom of feet.
⯈If the patient is a paralyzed, place hand role in
hand.
⯈Align the patient’s body in good position.

8. AIR BAGS FOOT BOARD

10. 2. PRONE POSITION
⯈Position in which the patient lies on the abdomen
with the head turned to one side with one small
pillow under the ankle.
Indications
⯈Post operatively
burns, injuries and
⯈Patient with pressure sores,
operations on the back.
⯈To relieve abdomen distension

11. CONTD..
Indications..
⯈Renal biopsy.
⯈Examine the back
⯈For patients after 24 hours of amputation of lower
limbs

12. PROCEDURE
⯈Explain the procedure
⯈Provide privacy
⯈Place the patient flat on abdomen with one pillow
under the head
⯈Turn patients head to one side and align the patient
in good position
⯈Place both arms at the side of the head and support
arm in flexed position at level of shoulder.
⯈Support lower legs with pillows to elevate toes.

14. 3. LATERAL POSITION
⯈The client lies on the side with weight on hip and
shoulder or the patient lies on his side with both
arms forward and his knees and hips flexed.
⯈The upper leg is flexed more than the lower leg.
⯈The upper knee and hip should be at the same
level.
⯈A pillow is given under the head, back and front to
support the arms and abdomen.
⯈A small pillow is given in between the knees.

15. INDICATIONS
⯈Patients who requires periodic position changes
⯈In immediate post-operative patients
⯈Used for examination of perineum
⯈Inserting suppositories.
⯈For taking rectal temperature.
⯈Giving back care
⯈For giving enema and colonic irrigation.

16. PROCEDURE
⯈Explain the procedure
⯈Provide privacy
⯈Lower the head of bed as low as patient can tolerate.
⯈Position the patient to side of bed
⯈Turn the patient to one side

17. CONTD..
⯈Place the air ring under the hips to reduce pressure in
trochanters and at the hip joints.
⯈Position both arms in flexed position. Upper most arms
are supported by pillow on level with shoulder.
⯈Place pillow under back
⯈Place pillow under semi flexed upper leg at hip, from
groin to foot.
⯈Place sand bag parallel to plantar surface of
dependent foot.

19. 4. LITHOTOMY POSITION
⯈The client lies supine with hips flexed. The legs are
separated and thighs are flexed.
⯈The patient’s buttocks are kept at the edge of the
table and legs are supported by stirrups.

20. INDICATIONS
⯈For delivery of baby
⯈For rectal examination & surgeries
⯈For vaginal examination & hysterectomy

21. PROCEDURE
⯈Explain the procedure to the patient
⯈Provide privacy
⯈Position the patient to lie on his back with one pillow
under the head
⯈Keep the legs well separated and the thighs well
flexed on the abdomen and the legs on the thighs
⯈Buttocks are kept on the edge of the table and the
legs are supported on stirrups

23. 5. DORSAL RECUMBENT POSITION
⯈Patient lies on back, knees fully flexed, thighs
flexed and externally rotated feet flat on the bed.
⯈ In this position clients with painful disorders are
more comfortable with knees flexed.
⯈This position should not be used for abdominal
assessment because it promotes contraction of
abdomen muscles.

24. INDICATIONS
douche,
⯈It is used for catheterization, vaginal
vulval, vaginal and rectal examination
⯈It is also used for vaginal operations and insertion
of tampons

25. PROCEDURE
⯈Place the patient on back in bed with two or more
pillows under the head for patient’s comfort.
⯈Place the air ring under the hips and cotton rings or
foam pads under the heels to reduce pressure.

27. 6. FOWLER’S POSITION
⯈It is a sitting position in which the head is elevated
at 45˚ to 60˚, and the client knees are slightly
elevated, avoiding pressure on the popliteal
vessels.
⯈Backrest and two pillows are used for the back and
head. Pillows can be used to maintain natural
alignment of the hands wrist and forearms.

31. INDICATIONS
⯈To relieve dyspnea
⯈To improve circulation
⯈To relax the muscles of the abdomen, back and
thighs.
⯈To relieve tension on abdominal stature.

32. PROCEDURE
⯈Explain the procedure
⯈Elevate the head of the bed
⯈Rest the head against mattress or small pillow.
⯈Use pillow to support arm.
⯈Place a small pillow at lower back.
⯈Place foot board at bottom of patient’s feet.
⯈Place the patient in sitting position with arms at sides
and knees raised with pillow.

34. 7. SIMS POSITION
⯈In this position the client lies on either the right or
left side.
⯈The lower arm behind the body and upper arm is
bent at the shoulder and elbow.
⯈The knees are both bent, with the upper most leg
more acutely bent.
⯈These positions similar to the lateral position except
that the patient’s weight is on the anterior aspect of
the patient’s shoulder girdle and hip.

35. INDICATIONS
⯈Vaginal and rectal examination
⯈Administration of enema and suppository
⯈Used for relaxation in antenatal exercises
⯈Position for sigmoidoscopy and protoscopy

36. SIGMOIDOSCOPY
PROTOSCOPY

37. PROCEDURE
⯈Explain the procedure to the patient
⯈Provide privacy
⯈Place the patient on the side
⯈Place small pillow under head and neck
⯈Place pillow under flexed upper arm, supporting arm
level with shoulder.
⯈Place pillow under flexed upper leg, supporting leg level
with hip.
⯈Place sand bags parallel to plantar surface of dependent
foot.

39. 8. TREDLENBERG POSITION
⯈In this the patient lies on the back with the head
low.
⯈The foot of the bed is elevated at 45˚ angle.
Entire frame of bed is tilted with head of bed
down.

40. INDICATION
⯈Used in emergency situations like shock,
hemorrhage and hypotension
⯈Postural drainage
⯈Patients with deep vein thrombosis

41. PROCEDURE
⯈Explain the procedure to patient
⯈Place the patient in supine position
⯈Lower the head end of the bed or if it is not
adjustable type, use bed block at foot end and tilt
entire frame of bed down. OR elevate the foot
end at 45˚angle.
⯈The patient is carefully supported to prevent
from slipping.

43. 9. KNEE CHEST POSITION
⯈The patient rests on the knees and the chest.
⯈The body is at 90˚ angle to the hips with back
straight, the arm above the head, and the head
turned to one side.
⯈The abdomen remains unsupported.

44. USES
⯈Used for vaginal and rectal examination
⯈Used in first aid treatment in cord prolapse or
retroverted uterus
⯈As exercise for postpartum and gynecology
patients.

45. PROCEDURE
⯈Explain the procedure to the patient
⯈Make the patient rest on the knees and chest
⯈The head is turned to one side with the cheek on
a pillow.
⯈The arm should be extended on the bed and
flexed at the elbows to support the patient
partially.

47. 10. ORTHOPNEIC POSITION
⯈High fowler’s position with over bed table to be
placed across the front of the patient.
⯈Patient to rest both hands on over bed table/on
pillow placed in it and leans forward.
⯈Leaning forward facilitates respiration by
allowing maximum chest expansion by reducing
pressure of abdominal organs on diaphragm.

48. INDICATIONS
⯈Patients with severe dyspnea
⯈Cardiac patients
⯈Position for thoracocentesis
⯈Patient with chest drainage tubes