M2: ROM, Therapeutic Positioning, Moving and Transferring

• Range of Motion (ROM)


  he maximum amount of movement available at a joint in one of the three planes of the body sagittal, frontal or transverse; is the complete extent of movement of which a joint is normally capable and without causing pain.
• Active ROM (Types of ROM)


   instructs the client to perform the movements of the non-functioning joint independently.
• Passive ROM (Types of ROM)


  performed by the nurse or other health care provider on a client’s immobilized joints.
• Active Assisted ROM (Types of ROM)


  carried out with both client and nurse participating. Encourage the client to carry out as much of each movement within limitations of strength and mobility. The nurse supports or completes the desired movement.
• Abduction


  the act of drawing away from the median line or center of the body 
• Adduction


  the act of drawing toward the median line or center of the body 
• Circumduction


  a circular movement of the body part
• Dorsiflexion


  bending or moving a part toward the dorsum or back
• Extension


  the act of straightening the joint
• Flexion


  bending of a joint
• Hyperextension


  extension of the joint beyond the straight position
• Lateral Flexion


  bending a joint toward the side or away from the midline of the body
• Opposition


  positioned opposite one another; for example, the thumb to the fingers
• Plantar Flexion


  bending the foot so that the toes point downward
• Rotation


  a circular movement around a fixed axis
• Therapeutic Positioning

  Correct positioning is crucial for maintaining body alignmentand comfort, preventing injury to the musculoskeletal andintegumentary systems, and providing sensory, motor andcognitive stimulation
• Positioning


  a patient in bed is important for maintaining alignment and for preventing bed sores, foot drop, and contractures.
• Transferring


  is a nursing skill that helps weakened or dependent patients or patients with restricted mobility attain positions to regain optimal independence as quickly as possible.
• Fowler's Position


  semi-sitting position, typically, refers to a 45°angle of elevation of the upper body. This position prevents posterior flexion of lumbar curvature; is the position of choice for people who have difficulty

  breathing and for some people with heart problems.
• Semi-Fowler's Position


  This position is sometimes called low Fowler’sand typically means 30 degrees of elevation.
• Orthopneic Position


  his position facilitates respiration by allowing maximum chest expansion. Itis particularly helpful to clients who have problems exhaling.
• Dorsal Recumbent Position


  The client’s head and shoulders are slightly elevated on a small pillow and the legs are slightly flexed. This position is used to provide comfort and facilitates healing following certain surgeries or anesthetics.
• Prone Position


  The client lies on the abdomen with the head turned to one side and hips are not flexed. The prone position also promotes drainage from the mouth and is useful for unconscious clients or those clients recovering from surgery of the mouth or throat. It also helps to prevent flexion contractures of the hips and knees.
• Lateral (side-lying) Position


  The client lies on one side of the body with the top leg in front of the bottom leg and the hip and knees flexed. Flexing the top hip and knee and placing this leg in front of the body creates a wider, triangular base of support and achieves greater stability. The greater the flexion of the top hip and knee, the greater the stability and balance in this position.
• Sim's (semi-prone) position


  the client assumes a posture halfway between the lateral and the prone positions. The lower arm is positioned behind the client, and the upper arm is flexed at the shoulder and the elbow. The upper leg is more acutely flexed at both the hip and the knee, than is the lower one. This position is use when there is multiple pressure ulcers and to improve respiratory function by promoting drainage.
• Knee Chest (genupectoral) Position


  this can be in lateral or prone position. In lateral knee-chest position, the patient lies on their side, torso lies diagonally across the table, hips and knees are flexed. In prone knee chest position (genupectoral), the patient kneels on the table and lower shoulders on to the table so chest and face rests on the table. This is a position assumed for gynecologic
• Lithotomy Position


  this position is which the patient is on her back with hips and kneesflexed and thighs apart and legs are supported by stirrups. It is often used for vaginalexaminations and childbirth.
• Trendelenburg’s Position


  this position involves lowering the head of the bed andraising the foot part of the patient’s bed. The patient’s arms should be tucked at theirsides. This position helps clients in shock in order to increase blood flow to heart andcerebral tissues
• Reverse Trendelenburg Position


  The position wherein the head of the bed is elevatedwith the foot of the bed down. It is the opposite of Trendelenburg position. It is oftenused for patients with gastrointestinal problems as it helps minimize esophageal reflux
• Jackknife (Kraske) Position


  This position is wherein the patient’s abdomen lies flat on bed. The bed is scissored so the hip is lifted and the legs and head are low. This is frequently used for surgeries involving the anus, rectum, coccyx, certain back surgeries, and adrenal surgery.