positioning & draping

5/23/2018 Positioning & Draping

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Jennifer S. Cruel, RN,MN


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POSITIONING & DRAPING

POSITIONING - to place or arrange the

client to assume a certain

position for physical

examination or treatment

DRAPING - a piece of cloth placed

over a patients body

during an examination oroperation


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GENERAL CONSIDERATIONS:

1. The method of draping vary with theposition of the patient, examination to be

done and temperature of the examination

room.2. Draping should be arranged so as to avoid

all unnecessary exposure, but at the same

time not to interfere with a thoroughexamination.


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3. Draping should be loose enough to allow a

quick change of position but anchored

securely so as not to be displaced by

patients movement.

4. Methods of draping should be designed

with consideration for those who are

embarrassed by exposure of the body.5. Draping should be warm whenever the

circumstances require it.


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ERECT OR STANDING POSITION

the head and body is held in an upright

position

PURPOSE:

1. For vaginal examination - to determine

the presence of prolapseuterus

2. For orthopedic condition


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PROCEDURE:

1. Assist patient to stand and put his slippersif floor is not covered.

2. Place a chair near one side where hand of

patient can rest for support.

3. For vaginal examination, elevate one foot

on a low stool.

4. Raise gown upward exposing only the areato be examined.


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HORIZONTAL RECUMBENT / SUPINE OR

DORSAL POSITION

Position in which the patient lies flat on the

back, with the head and shoulders also flat on

the bed

PURPOSE:

1. General physical examination

2. Various operative procedures

3. For comfort by providing a change in position


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PROCEDURE:

1. Have the patient lie on his back with the

legs extended or slightly flexed.2. Place pillow under the head and another

smaller one under the knees for support.

3. Arms be crossed on the chest or lie looselyat the sides of the body.

4. Put the sheet over the patient covering the

body completely from the neck to shouldersdownward without tucking it under the

mattress.


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DORSAL RECUMBENT POSITION

the patient lies flat on the back with head and

shoulders slightly elevated on a small pillow

PURPOSE:

1. Vaginal examination

2. Digital rectal examination (DRE)

3. Pelvic examination

4. For catheterization


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PROCEDURE:

1. Assist patient to lie flat on his back.

2. Separate the legs, flex the thighs so that the

soles of the feet rest on the bed.

3. Place the arms either above the head or flex

with the hands on the chest.

4. Place one pillow under the head.

5. Bring buttocks of the patient to the edge of

the bed.


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6. Drape with two sheets placed over the body

or with one sheet diagonally.

7. Place a sterile towel under the buttocks and

brings the ends up to cover the vulva while

waiting for the physician.


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DORSAL LITHOTOMY POSITION

back lying position with lower legs raised and

supported by stirrups

PURPOSE:

1. For cystoscopic examination

2. For vaginal delivery

3. For operations and examinations on the

perineum, vagina, cervix, bladder and rectum


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PROCEDURE:

1. Assist client to lie on her back.

2. Separate the legs and flexes the thighs deeplytoward the abdomen. Elevates the lower legs

and support them with stirrups.

3. Bring the buttocks to the edge of the table ora little beyond.

4. Raise the arms above the head or flexes them

with the hands on the chest.5. Draping is the same as in dorsal recumbent

position. Cover the vulva with towel in the

same manner.


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PRONE POSITION- the patient lies on the

abdomen with the head

turned to one side

PURPOSE:

1. Promotes drainage from the mouth

2. Useful for unconscious clients or those

recovering from surgery of the mouth or

throat


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PROCEDURE:

1. Help the patient to assume the horizontal

recumbent position.2. Assist him or her to turn over onto the

abdomen.

3. Turns the head to one side.4. Place arms at the sides or extends upwards.

5. Place a small pillow beneath the wrist and a

large one under the legs if patient has to stayin the position for a long time.

6. Draping is similar to that of the dorsal

position.


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TRENDELENBURG POSITION

the head and body are lowered

PURPOSE:

1. Used for surgery on the lower abdomen and

pelvis

2. For treatment of shock or decreased blood

pressure


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PROCEDURE:

1. Place the patient on his back.

2. Elevate the foot of the bed so that legs extendupward at 45 degrees angle. Head and

shoulders are lower that the hips and legs.

3. Draping depends upon the kind of operationto be performed and or similar to that of the

horizontal recumbent position.


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FOWLERS POSITION

the patient is semi-sitting with the head and

trunk elevated 45 to 90 degrees

PURPOSE:

1. Promoting cardiac and respiratory function

2. To relieve dyspnea

3. To facilitate drainage after surgery


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PROCEDURE:

1. Place the patient in horizontal recumbentposition.

2. Elevate the head of the bed to

approximately 45 degrees angle.

3. Flex the knees slightly and support them

with knee rolls.

4. Drape as in horizontal recumbent position.


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SIMS POSITION - the patient lies on one

side of the body

PURPOSE:

1. For resting sleeping

2. For unconscious clients

3. Used for paralyzed patient


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PROCEDURE:

1. Assist the patient to lie on either side,

preferably the left with the body inclinedforward.

2. Extend the left arm behind the back and flex

the elbow of the right arm forward.3. Flex the right thigh towards the abdomen

with the knees drawn up higher that the left

knee which is only slightly flexed.4. Lay out the draping sheet as in horizontal

position. Fold back or gather a side of the

sheet to expose the area to be examined.


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JACKNIFE POSITION - back lying

position with both legsraised perpendicularly

PURPOSE:1. For rectal surgery

2. For cystoscopic examination


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PROCEDURE:

1. Let the patient lie on his or her back with

shoulders slightly elevated.2. Bring thighs up to form a right angle with

the anterior part of the trunk and knees

flexed so that the lower legs rest against thethighs.

3. Draping depends on the operation to be

performed since this position is more forsurgery rather that for examination.


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KNEE-CHEST POSITION- patient lies on

the abdomen with kneesslightly separated on a

kneeling position and chest

resting on the bed.

PURPOSE:

1. For rectal examination and surgery


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PROCEDURE:

1. Place the patient in prone position.

2. Assist to kneel with the knees slightlyseparated.

3. Bend forward so that the chest is resting on

the bed.4. Turns the head to one side, extends hands

over head or flex at the elbows.

5. Be sure thighs are perpendicular.

6. Expose part to be examined only.


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ORTHOPNEIC POSITION

the patient sits either in bed or on the sideof the bed with an overbed table across the

lap

PURPOSE:

1. Facilitates respiration

2. For clients who have problems exhaling


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PROCEDURE:

1. Have patient sit up on bed.

2. Place overbed table across the lap.

3. Pad table with pillows and elevate to

comfortable height.

4. Let patient lean forward with head and

arms resting on table.

5. Cover with top sheet from waist downward.

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