Positions used in nursing

Recumbent Position

1. Position the patient on his or her back and place a pillow under his shoulders and head.
2. Support the lumbar curve with a rolled-up towel or a pillow.
3. If the arm is paralyzed, the forearm and hand may be positioned on a pillow. Flexion of the arm may occur if the upper arm is also placed on a pillow.
4. If flexion contractures in the hand are a possibility, a hand roll or a special hand splint may be used to prevent the formation of claw hand.
5. If the lower limbs are paralyzed, trochanter rolls may be placed along the lateral aspects of the thighs opposite the femoral trochanter to prevent rotation of the hips.
6. Maintain the knees in slight flexion by placing a pillow under the thighs superior to the popliteal space.
7. Use footboards or a folded pillow to support the feet in dorsal flexion.

Sim's position (Semi prone or recovery position)

1. Turn the patient in a lateral and slightly prone position with the bottom arm behind the back. Flex the top arm at the elbow and shoulder and position it with the fingers pointing to the head of the bed.
2. Place a pillow under the head and neck unless there are secretions.
3. Flex both legs at the knees and hips; the upper leg must be slightly more flexed to provide comfort.
4. Place a pillow between the legs to prevent friction.
5. Keep the feet in dorsal flexion using a rolled towel.

Prone position

1. Turn the patient on the abdomen to promote free drainage of oral and nasal secretions.
2. Turn the head laterally and position on a small pillow. A pillow may be placed just below the diaphragm.
3. Place a pillow under the lower legs or position the patient so that the feet hang over the edge of the mattress.

Lateral or side lying position

1. Turn the patient on the left or right side.
2. Place a pillow under the neck and head to prevent adduction of the upper hip and facilitate respiration.
3. Both arms are in flexion in front of the patient's body. Position the upper arm on a pillow and the lower one so that the fingers point to the head of the bed.
4. Flex both legs; the upper one more than the lower and place a pillow between the legs.
5. Place a pillow behind the patient's back.
6. Support the back with a rolled towel placed under the curve of the waist.

Lithotomy

1. Position the patient on her back with a pillow under the head and shoulder.
2. Two nurses are required; each one flexes one of the patient's legs over the abdomen and at the same time places her feet in the stirrups.
3. The patient's buttocks are positioned slightly over the edge of the theatre or examination table for proper exposure and easy performance of the procedure.
4. Position the patient's arms across the chest or by her sides on the bed.
5. Provide privacy by draping or covering the patient.

Sitting up (Orthopneic/Fowler's position)

Put the patient in a sitting up position and raise the backrest depending on the patient's demand.

Genu pectoral (knee chest position)

1. The patient kneels with the chest, head, and knees resting on the bed or table.
2. Slightly abduct the legs and hips.
3. Flex the knees at right angles to the body.
4. The feet protrude past the foot of the bed to ensure stable body alignment.
5. Place the patient's arms on the pillow.
6. Cover or drape the patient.

Trendelenburg position

The head is tilted down at an angle of 45 degrees.