Positioning

• Dorsal recumbent


  Back-lying position with knees flexed and hips externally rotated; small pillow under the head; soles of feet on the surface
• Dorsal recumbent


  Female genitals, rectum, and female reproductive tract
• Dorsal recumbent


  May be contraindicated for clients who have cardiopulmonary problems.
• Supine (horizontal recumbent)


  Back-lying position with legs extended; with or without pillow under the head
• Supine (horizontal recumbent)


  Head, neck, axillae, anterior thorax, lungs, breasts, heart, vital signs, abdomen, extremities, peripheral pulses
• Supine (horizontal recumbent)


  Tolerated poorly by clients with cardiovascular and respiratory problems.
• Sitting


  A seated position, back unsupported and legs hanging freely
• Sitting


  Head, neck, posterior and anterior thorax, lungs, breasts, axillae, heart, vital signs, upper and lower extremities, reflexes
• Sitting


  Older adults and weak clients may require support.
• Lithotomy


  Back-lying position with feet supported in stirrups; the hips should be in line with the edge of the table
• Lithotomy


  Female genitals, rectum, and female reproductive tract
• Lithotomy


  May be uncomfortable and tiring for older adults and often embarrassing.
• Sims’


  Side-lying position with lowermost arm behind the body, uppermost leg flexed at hip and knee, upper arm flexed at shoulder and elbow
• Sims’


  Rectum, vagina
• Sims’


  Difficult for older adults and people with limited joint movement.
• Prone


  Lies on abdomen with head turned to the side, with or without a small pillow
• Prone


  Posterior thorax, hip joint movement
• Prone


  Often not tolerated by older adults and people with cardiovascular and respiratory problems.
• SITTING POSITION


  The client should sit upright on the side of the examination table.
• SITTING POSITION


  In the home or office setting, the client can sit on the edge of a chair or bed.
• SITTING POSITION


  This position is good for evaluating the head, neck, lungs, chest, back, breasts, axillae, heart, vital signs, and upper extremities.
• SITTING POSITION


  This position is also useful because it permits full expansion

  of the lungs and it allows the examiner to assess symmetry of upper body parts.
• SITTING POSITION


  Some clients may be too weak to sit up for the entire examination. They may need to lie down, face up (supine position), and rest throughout the examination.
• SITTING POSITION


  Other clients may be unable to tolerate the position for any length of time. An alternative position is for the client to lie down with head elevated.
• SITTING POSITION


  What position?

  
• SUPINE POSITION


  Ask the client to lie down with the legs together on the examination table (or bed if in a home setting).
• SUPINE POSITION


  A small pillow may be placed under the head to promote comfort. If the client has trouble breathing, the head of the bed may need to be raised.
• SUPINE POSITION


  This position allows the abdominal muscles to relax and provides easy access to peripheral pulse sites.
• SUPINE POSITION


  Areas assessed with the client in this position may include head, neck, chest, breasts, axillae, abdomen, heart, lungs, and all extremities.
• SUPINE POSITION


  What position?

  
• DORSAL RECUMBENT POSITION


  The client lies down on the examination table or bed with the knees bent, the legs separated, and the feet flat on the table or the bed.
• DORSAL RECUMBENT POSITION


  This position may be more comfortable than the supine position for clients with pain in the back or the abdomen.
• DORSAL RECUMBENT POSITION


  Areas that may be assessed with the client in this position include head, neck, chest, axillae, lungs, heart, extremities, breasts, and peripheral pulses.
• DORSAL RECUMBENT POSITION


  The abdomen should not be assessed because the abdominal muscles are contracted in this position.
• DORSAL RECUMBENT POSITION


  What position?

  
• SIMS POSITION


  The client lies on the right or left side with the lower arm placed behind the body and the upper arm flexed at the shoulder and the elbow.
• SIMS POSITION


  The lower leg is slightly flexed at the knee, while the upper leg is flexed at a sharper angle and pulled forward.
• SIMS POSITION


  This position is useful for assessing the rectal and vaginal areas.
• SIMS POSITION


  The client may need some assistance getting into this position.
• SIMS POSITION


  Clients with joint problems and elderly clients may have some difficulty assuming and maintaining this position.