How Should the Patient Positioning Positions Be?

What is the Low Fowler?
23 January 2021
Hepsini Göster
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Supine Position-Flat

Procedures/Conditions
Post Cardiac Cath
Post Cerebral
Angiography
Liver-Lung Biopsy, Puncture
Shock-Spinal Injuries

The Nurses Notes
Think, Procedural since this position is used for surgical procedures of the abdomen, face, and extremities. Aldı for suspected Spinal/neck injury and when immobilization is necessary. Good for SHOCK patients, and pier Cath Procedure is to prevent bleeding usually 6 hours may raise up to 30° Post Lumbar Puncture 4-12 hour’s.

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Low Fowlers

Procedures/Conditions
Neurological Patients 15°-30

The Nurses Notes
Think ” neuro ” patients or surgical neuro patients are to be kept at this position (15°-30°) to keep ICP in normal rangers preventing herniation it complications. (45° is sometimes used for neuro pt’s)

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Semi-Fowlers

Procedures/Conditions
SEMI FOWLERS 30°-45°
Labor Patients, Mastectomy Cirrhosis, AAA, Craniotomy, Laryngectomy, Paracentesis, Tube Feedings

The Nurses Notes
Semi-fowlers 30°-45° used for labor to promote comfort along with Liver disease with ascites, sickle cell, post-op abdominal aneurysms Craniotomy with head midline, mastectomy arm elevated, also used for tube feeding and paracentesis during the procedure.

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Fowlers

Procedures/Conditions
FOWLERS – 45°
Post Bronchoscopy Myocardial Infarction Nasogastric Tube Appendectomy

The Nurses Notes
Fowlers 45° is generally normal positioning for patients. Used in post bronchoscopy and patients with MI it is the standard position that promotes lung expansion and prevents risk of aspiration post sedation procedure. Patients with an NG tube will also be in fowlers when not having feedings.

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High Fowlers

Procedures/Conditions
NG Tube Insertion ACUTE Respiratory Conditions CHF-Pleural Effusions Thyroidectomy COPD-Pneumothorax Autonomic Dysreflexia

The Nurses Notes
High fowlers position is used for initial placement of NG Tube insertion. Acute position recommended for all patients in distress though is not a long term position. Provides support of interventions by expansion of lungs and promoting ventilation oxygenation while in acute respiratory distress. Patiens with Spinal injuries above T6 are at risk for Autonomic Dysreflexia and Initial action is high fowlers or dangled acute positioning.

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Dangle Feet off side

Procedures/Conditions
CHF Orthostatic Patiens First Dose Antibiotics

The Nurses Notes
Patients with CHF may be most comfortable in this position since ir promotes lung expansion patient safety should be monitored First Dose ARBS and some ACE inhibitors have risk for Orthostatic Hypotension so patients should first dangle before rising out of bed.

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Orthopneic-Tripod

Procedures/Conditions
Pericarditis COPD Thoracentesis (position for procedure)

The Nurses Notes
Patients with invasive procedures around the heart are at risk for pericarditis (rubbing sound) and cardiac tamponade (muffled heart sounds), assuming this position often alleviates the pain associated with this condition. Patients with COPD are taught pursed lip breathing and the tripod position to help facilitate oxygenation.