Procedures and their positions

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Good Afternoon All,

I am scheduled to take my Nclex in August. I am having a hard time with the position ex Supine,semi fowlers and dorsal recumbent.If a pt has a lobectomy how should they be positioned. Can anyone please help me with this. Thanks

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If I had to answer, I would say semi-Fowlers to keep swelling from the head.

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Specializes in IMCU.
Good Afternoon All,

I am scheduled to take my Nclex in August. I am having a hard time with the position ex Supine,semi fowlers and dorsal recumbent.If a pt has a lobectomy how should they be positioned. Can anyone please help me with this. Thanks

Can I presume you mean lung lobe?

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I guess my question is what positions are used for what situations

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I am actually having a hard time locating information for the same question!

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This is out of the study guide that floats around here. Hope it helps :)

1. Air/Pulmonary Embolism (S&S: chest pain, difficulty breathing, tachycardia, pale/cyanotic,sense of impending doom) --> turn pt to left side and lower the head of the bed.

2. Woman in Labor w/ Un-reassuring FHR (late decels, decreased variability, fetalbradycardia, etc) --> turn on left side (and give O2, stop Pitocin, increase IV fluids)

3. Tube Feeding w/ Decreased LOC --> position pt on right side (promotes emptying of thestomach) with the HOB elevated (to prevent aspiration)

4. During Epidural Puncture --> side-lying

5. After Lumbar Puncture (and also oil-based Myelogram)--> pt lies in flat supine (to preventheadache and leaking of CSF)

6. Pt w/ Heat Stroke --> lie flat w/ legs elevated

7. During Continuous Bladder Irrigation (CBI) --> catheter is taped to thigh so leg should bekept straight. No other positioning restrictions.

8. After Myringotomy --> position on side of affected ear after surgery (allows drainage ofsecretions)

9. After Cataract Surgery --> pt will sleep on unaffected side with a night shield for 1-4weeks.

10. After Thyroidectomy --> low or semi-Fowler's, support head, neck and shoulders.

11. Infant w/ Spina Bifida --> position prone (on abdomen) so that sac does not rupture12. Buck's Traction (skin traction) --> elevate foot of bed for counter-traction

13. After Total Hip Replacement --> don't sleep on operated side, don't flex hip more than 45-60 degrees, don't elevate HOB more than 45 degrees. Maintain hip abduction by separatingthighs with pillows.

14. Prolapsed Cord --> knee-chest position or Trendelenburg

15. Infant w/ Cleft Lip --> position on back or in infant seat to prevent trauma to suture line.While feeding, hold in upright position.

16. To Prevent Dumping Syndrome (post-operative ulcer/stomach surgeries) --> eat inreclining position, lie down after meals for

20-30 minutes (also restrict fluids during meals, lowCHO and fiber diet, small frequent meals)

17. Above Knee Amputation --> elevate for first 24 hours on pillow, position prone daily toprovide for hip extension.

18. Below Knee Amputation --> foot of bed elevated for first 24 hours, position prone daily toprovide for hip extension.

19. Detached Retina --> area of detachment should be in the dependent position

20. Administration of Enema --> position pt in left side-lying (Sim's) with knee flexed

21. After Supratentorial Surgery (incision behind hairline) --> elevate HOB 30-45 degrees

22. After Infratentorial Surgery (incision at nape of neck)--> position pt flat and lateral oneither side.

23. During Internal Radiation --> on bedrest while implant in place

24. Autonomic Dysreflexia/Hyperreflexia (S&S: pounding headache, profuse sweating, nasalcongestion, goose flesh, bradycardia, hypertension) --> place client in sitting position (elevateHOB) first before any other implementation.

25. Shock --> bedrest with extremities elevated 20 degrees, knees straight, head slightlyelevated (modified Trendelenburg)

26. Head Injury --> elevate HOB 30 degrees to decrease intracranial pressure

27. Peritoneal Dialysis when Outflow is Inadequate --> turn pt from side to side BEFORE checking for kinks in tubing (according to Kaplan)

28. Lumbar puncture => AFTER the procedure, the client should be placed in the supineposition for 4 to 12 hrs as prescribed. (Saunders 3rd ed p. 229)

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