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39 Cards in this Set
- Front
- Back
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Autograft
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immobilized 3-7 days -- graft to adhere and attach to wound bed
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**Burns of face and head
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elevate head of bed to prevent or reduce facial head, tracheal edema
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Skin graft
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elevate and immobilize graft site
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circumferential burns of extremeties
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elevate extremeties above level of the heart to reduce dependent edema
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Mastectomy
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HOB at least 30 degrees with affected arm elevated on a pillow to promote lymphatic fluid return after removal of axillary lymph nodes
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Hypophysectomy
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elevate HOB
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** Thyroidectomy
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Semi-fowlers to reduce swelling and edema in neck area -- pillow to support neck
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Hemorrhoiectomy
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lateral side-lying to prevent pain and bleeding
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Liver biopsy
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During procedure -- supine with right side of abdomen exposed -- right arm raised and extended over left shoulder behind head
After procedure -- lateral - sidelying position -- small pillow or folded towel under puncture site for at least 3 hours |
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Intestinal tubes (miller-abbott, cantor, harris)
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rotate as prescribed -- 2 hours right -- 2 hours back -- 2 hours left -- elevate hob
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NG
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Insertion -- High-fowlers with head tilted forward
Irrigations and tube feeding -- semi-fowlers -- keep elevated for 1 hour after an intermittent feeding and keep elevated for continuous feeding |
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Rectal enema/irrigation --
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left sims
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Sengstaken-Blakemore and Minnesota --
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Elevate HOB to enhance lung expansion and reduce portal blood flow -- permit effective compression of varices
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COPD
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sitting, leaning forward, with arms over several pillows or an overbed table
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Laryngectomy (radical neck dissection)
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semi-fowler or fowler
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Bronchoscopy post
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semi-fowlers
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Postural drainaged
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lung segment to be drained in uppermost position
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Thoracentesis
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During -- sittig on edge of bed, leaning over table with feet on stool or ling in bed on unaffected side with HOB fowlers
After procedure -- comfort position |
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Thoractomy **
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check physician order
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Abdominal aneurysm resection
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limit elevation of HOB to 45 degrees -- turn from side to side regularly
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Amputation of lower extremity **
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first 24 elevate foot of bed then keep flat to prevent hip flexion contractures -- prone every 3 to 4 hours for twenty minutes -- keep legs close together to prevent abduction -- contract gluteal muscles
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arterial vascular grafting of extremeity
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bed rest for 24 hours and extremity is kept straight -- limit movement and avoid flexion of hip and knee
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Cardiac cath ***
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extremity that cath inserted kept straight 4-6 hours -- femoral artery then bedrest 6-12 hours (client can turn from side to side) -- leg kept straight and HOB no more than semi-fowler until hemostasis
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** CHF/Pulmonary edema
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upright with legs dangling to decrease venous return and lung congestion
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Thrombophletibis
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bed rest with elevated of affected extremity -- no knee gatch or pillow placed under
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Vein ligation and stripping
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elevate feet above level of heart -- no leg dangle or chair sit
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Cataract
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post -- elevate HOB 30 to 45 -- back or nonoperative side to prevent development of edema
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Retinal reattachment
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physicians order for position
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Autonomic dysreflexia --
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High Fowler
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Cerebral aneurysm
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complete bedrest with HOB elevated to 30 to 45
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Cerebral angiography
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bedrest for 6 to 24 hours as prescribed
extremity kept straight and immobilized |
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CVA
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Hemorrhagic strokes -- semi fowler
Ischemic strokes -- flat -- Head in midline neutral position -- avoid extreme hip (increase intrathoracic pressure) and neck ( prohibit venous drainage) flexion |
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Craniotomy
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don't position on operative site especially if bone flap removed -- HOB at 30 to 45 degrees -- head midline, neutral
avoid extreme hip and neck flexion |
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Laminectomy
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log roll client -- straight back chair with feet on floor
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ICP
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30 to 45 degrees, head midline -- avoid extreme hip and neck flexion
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Lumbar puncture
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lateral (side-lying) with back bowed at edge of table -- after put pt. in supine position for 4 to 12 hours
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Myelogram
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water-soluble dye used -- HOB elevated for at least 8 hours -- oil based dye than position flat in bed to 6-8
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** spinal cord injury
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head immobilized
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** Hip Surgery
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avoid extreme positions and acute flexion of operative hip and keep affected leg abducted -- pillow between legs -- prevent external rotation by placing trochanter role bedside external aspect
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