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CNA Skill #3: Positioning, Turning, Moving, and Transferring Pts.
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CNA Skill #3: Positioning, Turning, Moving, and Transferring Pts As a health care worker, you may be responsible for positioning turning, moving, and transferring many patients. If these procedures are done correctly, you will provide the patient with optimum comfort and care.In addition, you will prevent injury to yourself and the patient.
Safety Measures: • Correct body mechanics are essential. • If you are unable to move a pt by yourself, always seek assistance.
Alignment TO • Def – Positioning body parts in relation to each other to maintain correct posture. • Prevents: 1. Fatigue b/c comfortable • Pressure Sores • Contractures
2. Pressure Sores • AKA Bed Sores • Result of pressure on an area that interferes c circulation. • Common Areas: • Where bones are superficial to skin i.e. Coccygeal area, hips, knees, elbows
Development of P Sores: • 1st sign: pale/redness of skin. • Vesicle/blister may form at site. • As cells die, skin breaks down leaving an ulcer/open sore.
Prevention of P Sores: • Good skin care • Clean urine/feces promptly • Massage reddened area in circular motion • Apply dusting of powder to high friction areas
Turn pt frequently to change positions. • Position to avoid pressure on irritated areas • Linen dry/wrinkle free • Observer skin carefully during bathing/turning • Report pale or reddened areas STAT
3. Contractures • Def – tightening or shortening of a mm due to lack of mvmt or usage. • Common = Foot Drop
Prevention of Contractures: • Keep feet at right angles to the legs. • Using footboards & high-top tennis shoes to keep foot in this position • ROM exrsfor extremities
Moves & Turns • Pts confined to bed must be turned frequently. • Minimum q2 hrs if permitted by physician.
Why? • Provides exrs for mm • Stimulates circulation • Helps prevent pressure sores/contractures. • Provides pt comfort
How? Dangling • Sitting pt c legs hanging down over the side of the bed. • Pt frequently placed in this position prior to being transferred from bed if confined for a period of time.
P is ck 3x during procedure: • Before pt is moved – resting control rate. • STAT post after positioning pt in dangling. • After returning pt to lying position. • Changes in PR helps determine how well pt tolerates procedure.
Also observe: • R – dyspnea? • Ck balance, note vertigo. • Note amount of perspiration/color.
Return Pt STAT TO SUPINE IF: • Excessive inc in PR or weak P. • Signs of dyspena. • Skin becomes pale or inc in perspiration. • Pt experiences vertigo.
Transfers • Pts transferred to wheelchairs, chairs, stretchers. • Many models out there so ask if unsure how to operate. • Correct procedures must be followed to prevent injury to pt & worker.
Transfer Procedure: • Place bed in low position. • Raise HOB. • Ck resting P. • Assist pt to dangle, ck P. • Allow time to adjust. • Apply gait belt, stand one ft in b/w pt’s. • Lift & turn to wheelchair. • Gently lower c/ 1 ft in b/w pt’s.
Mechanical Lifts • Used too transfer weak or paralyzed pts. • Ck straps, clasps, sling for defects. • Smooth-even mvmts while operating.
Reassure frightened pts. • Move unnecessary furniture out of the way. • Important in home care situations.
1/30/14 Daily Cerebral Exercise:(write Q & A) • When do we ck radial pulse in dangling a pt? • Why is it important to reposition a pt every 2hrs? • When dangling a pt, what indications are their for returning to supine position?
1/22/14 Warm-up – HST 1 Review Lack of oxygen/blood to vital organs. Keep warm, lie down, call 911, NO food or water • What is shock? Minimize effects? • Differentiate between disease and disability? • List the six essential nutrients. Dz – condition interferes c/ normal function of body. Disability – phy/men defect that interferes c function of body CHO, Lipids, Proteins, Vitamins, Minerals, H20.