Chapter 10-3 PDF

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chapter 10 cna notes...

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Chapter 10: Positioning, Transfers, and Ambulation •

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Body mechanics o Face what you are lifting o Back straight o Head up shoulders back o Squatting position and left with lefts bend at hips and knees o Tighten stomach muscles when beginning the lift o Object close to the body o Push when possible rather than lift Explain positioning and describe how to safely position residents o Positioning: helping residents into positions that promote comfort and health o Bedbound: every 2 hours moved o Wheelchair: ever hour o Each time there is a move, na needs to document o Positioning depends on diagnosis and care plans o Supine ▪ Flat on back ▪ Heald and shoulders supported with pillow ▪ Pillows can also support arms or hands and pillow placed under calves so heels are elevated o Lateral/side ▪ Pillow under head ▪ Pillow supporting top arm ▪ Pillow under knee ▪ Top knee bent under pillow ▪ Bottom foot under pillow o Prone ▪ Lying on stomach ▪ Head under pillow ▪ Feet under pillow ▪ Hands by side o Fowlers ▪ Semi sitting: 45-60 degrees ▪ Knees flexed and elevated with pillow underneath ▪ Spine strait ▪ High fowler: 60-90 degrees o Sims ▪ Left side laying position ▪ Lyng on stomach ▪ Head under pillow

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▪ Right arm bent toward head under pillow ▪ Left arm strait down ▪ Right knee bent upward under pillow ▪ Left leg strait and foot under pillow Draw sheet: extra sheet placed on top of bottom sheet when the bed is made, prevent skin damage caused by shearing ▪ Shearing: rubbing or friction that results from the skin moving one-way na dth ebone underneath it remaining fixed or moving in the opposite direction ▪ Draw sheet flat under body Moving resident up in bed: ▪ One arm under shoulder blades and other under thighs ▪ Bend residents' knees and feet on mattress and push with her feet and hands on count of three ▪ On three, shift body weight to help move the resident Moving resident to the side of the bed ▪ Stand on the side of bed to which you are moving resident ▪ Slide hands under resident's head and shoulders and move them toward you Positioning a resident on the left side ▪ Move resident toward the right side of bed using previous procedures ▪ Cross residents right arm over chest ▪ Move left arm out of the way ▪ Cross right leg over left leg ▪ Place one hand on resident's right shoulder and other on right hip ▪ While supporting the body, roll resident onto his left side Positioning resident properly: ▪ Head supported by pillow ▪ Shoulder adjusted so resident is not lying on his arm or hand ▪ Top arm supported by pillow ▪ Back supported by supportive device ▪ Top knee flexed ▪ Supportive device between legs with top knee flexed; knee and ankle supported ▪ Pillow under bottom foot Log rolling: ▪ When spinal columns must be kept in alignment ▪ Moving resident as a unit ▪ Everything in a strait light ▪ Both people stand on same side of bed ▪ One at shoulder other and midsection

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▪ Pillow under head to support neck during the move ▪ Arms across chest and pillow between knees ▪ Feet shoulder width apart, bend your knees ▪ Grasp the draw sheet on the far side ▪ Roll resident toward you o Dangle: ▪ Sit up on side of bed with legs hanging over side ▪ Regain balance ▪ Sitting position ▪ Turn to side ▪ Top arm across chest ▪ Then move into totally seated position o Safely transfer residents ▪ Ergonomics: science of designing equipment, areas, and work tasks to make them safer and to suit the workers abilities ▪ Many places have lift free policies ▪ Transfer belt: safety device used to transfer residents who are weak ▪ Gait belt: help residents walk ▪ Slide board: used to transfer residents who are unable to bear weight on their legs ▪ Stand up lift: used when a person can bear some weight on his legs but has poor leg strength and or balance ▪ Toilet transfers: Transferring a resident onto and off a toilet o Position wheelchair at right angle to the toilet to face the hand bar/wall rail o Place wheelchair on the residents stronger side o Remove wheelchair footrests and lock wheels o Apply transfer belt around residents waist over clothing o Ask resident to push against armrests of the wheelchair and stand, reaching for and grasping the hand bar with her stronger arm o Pivot her foot and back up so that she can feel the front of the toilet with the back of her legs o Pull down pants o Slowly sit Into vehicle o Place wc at 45 degree angle o Open door on residents stronger side o Lock wheels o Push against armrests of wheelchair to stand, grasp vehicle and pivot foot o Sit in seat and left one leg then the other into the vehicle

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Ambulate residents o Ambulate: walking o Ambulatory: get out of bed and walk o Walk behind and to one side of the resident o Visually impaired: walk beside and slightly behind her as he rests a hand on the nas elbow o Walk at normal pace o C cane: improve balance o Functional grip cane: straight grip handle rather ten curved. Helps improve grip control and provides more support o Quad cane: four rubber tipped for more weight o Walker: resident bear some weight on both legs o Walker moved first then weak leg then stronger leg o Cane: placed on stronger side o Before ambulating ▪ Non skid socks ▪ Stand in front of resident ▪ Place gait belt ▪...