• reverse Trendelenburg’s position is the opposite of Trendelenburg’s position: The head of the bed is elevated with the foot of the bed down. 
• This is often a position of comfort for patients with gastrointestinal problems, and it can help prevent or minimize esophageal reflux.

• Placing a patient in Trendelenburg’s position involves lowering the head of the bed and raising the foot of the bed. 
• Patients who have hypotension can benefit from this position because it promotes venous return.

• For semi-Fowler’s position, the head of the bed is elevated 30 degrees. 
• This position is useful for patients who have cardiac, respiratory, or neurological problems and is often optimal for patients who have a nasogastric tube in place.

• Patients are often placed in Fowler’s position to increase comfort, to improve ventilation, and to promote relaxation after thoracic surgery or for patients with cardiovascular problems. 
• For this position, the head of the bed is elevated 45 degrees. The patient’s hips may or may not be flexed. 
• You’ll place pillows behind the patient’s head and lower back and underneath the forearms, thighs, and ankles for support. 
• You might also use a footboard to keep the patient’s feet in proper alignment and to help prevent footdrop.

• Patients who have breathing problems are often placed in the orthopneic, or tripod, position since it allows maximum expansion of the chest. 
• For this position, the patient sits in bed or on the side of the bed with an overbed table in front to lean on and several pillows on the table to rest on.

• patient is halfway between the lateral and the prone positions. The upper arm is flexed at the shoulder and elbow, and the lower arm is positioned behind the patient. Both legs are in a flexed position in front of the patient, with the upper leg more flexed than the lower one. 
• This position is most often used when patients are receiving an enema or for an examination of the perineal area.
• To keep the body in proper alignment in this position, place a pillow underneath the patient’s head and under the upper arm to prevent internal rotation. Place another pillow between the legs.

• In the lateral or side-lying position, the patient lies on one side of the body with the top leg in front of the bottom leg and the hip and knee flexed. 
• This position helps relieve pressure on the sacrum and is especially useful for patients who are on bed rest and spend a lot of time supine or in Fowler’s position. 
• To maintain proper body alignment in this position, place a pillow under the patient’s head and neck, another under the upper arm (with the lower arm flexed), and another between the legs to keep the hips properly aligned.

• In the prone position, the patient lies on the abdomen with the head turned to one side. The hips are not flexed. Sometimes, one or both arms are flexed on each side of the patient’s head. 
• Because this position can cause hyperextension of the lower back, difficulty breathing due to pressure on the chest, and foot drop, it is not a position you’ll use often. 
• If a patient does lie prone, place a pillow under the patient’s head and a small pillow or towel roll under the abdomen just below the diaphragm. Also, place a pillow under the lower legs to keep the toes from touching the bed

• The supine position provides comfort in general and specifically for patients recovering from some types of surgery. 
• To provide support and maintain body alignment in this position, place a pillow under the patient’s head and shoulders and a towel roll or small pillow under the small of the back and under the thighs to keep the patient’s knees slightly flexed. You can also elevate the patient’s forearms on pillows placed at the patient’s sides.

1. lateral flexion: ear to one shoulder and then the other
2. rotation: look to the left and then to the right
3. Flexion: chin to chest
4. extension: head straight looking forward
5. hyperextension: head back, looking up

1. flexion
2. extension

1. abduction (radial flexion)
2. adduction (ulnar flexion)
3. Flexion: bend palm toward forearm
4. extension: bend back to hand toward forearm, about 45 degree angle
5. hyperextension: about 75 degree angle

1. flexion: bend knee and hip
2. extension: leg backward about 45 degrees
3. hyperextension: past 45 degrees
4. abduction
5. adduction
6. circumduction
7. external rotation
8. internal rotation

1. Flexion: heel towards butt
2. Extension: VERY SMALL amount forward from straight leg position

Documentation:

Ambulation

Documenting: 

Transferring

• the type of transfer performed (bed to chair, bed to gurney)
• the patient’s level of participation
• the level of assistance the patient required
• assistive devices used to complete the transfer (transfer board, transfer belt)
• the patient’s response to the transfer
• patient and family teaching done

Documenting:

ROM

• the patient’s level of participation
• the specific joint or joints exercised
• any changes in the condition or mobility of the joint
• any movements that caused pain or discomfort
• the patient’s response to range-of-motion exercises
• patient and family teaching done

Documenting:

Positioning

• the patient’s level of participation
• the number of staff needed to position the patient
• the use of a foot board, trochanter roll, or hand roll
• the condition of the patient’s skin
• the patient’s response to being moved or repositioned
• patient and family teaching done

Documenting:

Elastic Stockings and Sequential Compression Devices

Documenting:

Continuous Passive Motion Machiene

• the rate of cycles per minute and the degree of flexion and extension
• the condition of the patient’s skin and operative site
• the length of time the machine was on and off
• the patient’s response to the machine
• patient and family teaching done