BODY MECHANICS

• Body mechanics


  The safest and most efficient methods of moving and lifting
• Principles of body mechanics

  • Center of gravity
  • Base of support
  • Line of gravity
• Center of gravity


  The point where approximately half the body weight is distributed above and half below, and half to each side
• When lifting an object, bend at the knees and hips and keep the back straight to maintain balance
• Base of support


  The distance between the feet, with one foot slightly in front of the other for back-to-front stability
• Line of gravity


  An imaginary straight line connecting the nose, breastbone, and pubic bone when the body is in proper alignment
• Proper body alignment is essential to maintain balance and prevent muscle strain
• Client positions

  • Supine
  • Prone
  • Lateral
  • Sims'
  • Fowler's
  • Orthopneic
  • Lithotomy
  • Standing
• Proper positioning of client

  • Maintain functional body alignment
  • Maintain client safety
  • Reassure client to promote comfort and cooperation
  • Properly handle client's body to prevent pain or injury
  • Follow proper body mechanics to protect self and client
  • Obtain assistance if needed to move heavy or immobile clients
  • Follow specific provider's orders
• A specific order is needed for a client to be out of bed
• Special devices (e.g. splints, traction) should not be used unless ordered and the nurse is trained to use the equipment
• The client should be made comfortable and have the nurse signal cord available after positioning
• A urine specimen is collected as ordered
• The client is encouraged to defecate before most examinations, particularly a rectal examination
• The client is provided with an examination gown and/or bath towel to cover the chest and perineal area
• A bath blanket or sheet is provided for warmth and privacy, and a small pillow may be provided in some cases
• The examination procedure is explained to the client
• The body is draped appropriately for client privacy and examiner's access
• Appropriate lighting is provided for the examiner
• Needed equipment and supplies are prepared before the examination begins
• The nurse stays with the client during the examination
• Examiner and nurse wash or sanitize their hands before and after any examination
• Gloves are worn in many cases, and other personal protective equipment is worn when needed
• A signed release is obtained from the client when needed
• The nurse observes, documents the procedure, maintains client safety and confidentiality, provides comfort to the client, and answers questions
• After the examination, the nurse assists in disposing of equipment and supplies and readying the examination room for the next examination
• The nurse needs to know why the examination is being done to answer the client's questions and anticipate problems
• Fowler's Position


  Used for examinations and treatments of the head, neck, and chest or for patients who find it difficult to breathe lying down. The patient sits on the examination table with the head of the table elevated 90 degrees or simply sits at the edge of the table. The drape will vary according to the exposure of the patient.
• Semi-Fowler Position


  Used for post-surgical examinations, with patients with breathing disorders, or elevated temperatures or head trauma or pain. It is a modification of Fowler's position, the head of the table is at 45-degree angle. The drape and/or gown should cover the entire patient from the nipple line down.
• Sim's Lateral Position


  Used for rectal examinations, instillation of rectal medications, and perineal and some pelvic examination. Patient is on left side with right knee flexed against abdomen and left knee slightly flexed and the buttocks are pulled to the edge of the table. Left arm is behind body; right arm is placed comfortably. The drape extends diagonally from under the arms to below the knees.
• Knee-Chest Position


  Used for rectal examination. Patient is on knees with chest and elbows resting on bed or arms above head. Head is turned to one side. Thighs are straight and slightly separated, the buttocks extends up to the air and lower legs are flat on bed. The gown should open in the back, with a fenestrated opening drape or a single sheet draped diagonally over the patient's back at the sacral area.
• Reverse Trendelenburg's Position


  A supine position with the patient on a plane inclined with the head higher than the rest of the body and appropriate safety devices such as a footboard.
• Trendelenburg's Position


  The patient is on the back on a table or bed whose upper section is inclined 45 degrees so that the head is lower than the rest of the body; the adjustable lower section of the table or bed is bent so that the patient's legs and knees are flexed. There is support to keep the patient from slipping.
• Lateral Recumbent Position


  Lying on right side, knees and head flexed as sharply as possible; back exposed. Held in position by healthcare worker.
• Trendelenburg's Position


  Head lower than feet. (May be simulated using pillows under feet in emergency.) Place pillow between client's head and headboard of bed.
• Reverse Trendelenburg's Position


  Head higher than feet. Place pillow between client's feet and footboard of bed.
• Neck Pivot Joint


  • Flexion: Move the head 45° from midline forward, so that the chin rests on the chest
  • Extension: Move the head from the flexed position to the upright position
  • Hyperextension: Move the head from the upright position back as far as possible
  • Lateral flexion: Move the head laterally to the right and left shoulders
  • Rotation: Turn the face as far as possible to the right and left
• Shoulder-Ball-and-Socket Joint

  • Flexion: Raise each arm from a position by the side forward and upward to a position beside the head
  • Extension: Move each arm from a vertical position beside the head forward and down to a resting position at the side of the body
  • Hyperextension: Move each arm from a resting side position to behind the body
  • Abduction: Move each arm laterally from a resting position at the sides to a side position above the head, palm of the hand either toward or away from the head
  • Adduction (anterior): Move each arm from a position at the sides across the front of the body as far as possible
  • Circumduction: Move each arm forward, up, back, and down in a full circle
  • External rotation: With each arm held out to the side at shoulder level and the elbow bent to a right angle, fingers pointing down, move the arm upward so that the fingers point up
  • Internal rotation: With each arm held out to the side at shoulder level and the elbow bent to a right angle, fingers pointing up, bring the arm forward and down so that the fingers point down
• Elbow-Hinge Joint

  • Flexion: Bring each lower arm forward and upward so that the hand is at the shoulder
  • Extension: Bring each lower arm forward and downward, straightening the arm
  • Rotation for supination: Turn each hand and forearm so that the palm is facing upward
  • Rotation for pronation: Turn each hand and forearm so that the palm is facing downward
• Wrist-Condyloid Joint

  • Flexion: Bring the fingers of each hand toward the inner aspect of the forearm
  • Extension: Straighten each hand to the same plane as the arm
  • Hyperextension: Bend the fingers of each hand back as far as possible
  • Radial flexion (abduction): Bend each wrist laterally toward the thumb side with hand supinated
  • Ulnar flexion (adduction): Bend each wrist laterally toward the fifth finger with the hand supinated