Body Mechanics

Principles of Body Mechanics
– rules that allow you to move your body without causing injury
– stand in proper body alignment
– use a wide base of support
– squat to lift heavy objects from the floor
– keep objects close to the body when lifiting or carrying
– avoid twisting – turn body in one plane
– use both hands and arms when moving, lifitng, or carrying heavy objects
– push, pull, or slide heavy objects whenever possible rather than lifting
– have a good grip on clients or objects before attemtping to move them
– get help when needed

Body Mechanics
– use arms and legs, not back
– slide the client toward you with the draw sheet
– person with heaviest load coordinates the lift
– perform manual lifting as a last resort and if it does not involve lifting most or all of the client’s weight

– frequent position changes help to:
– prevent muscle discomfort
– decrease pressure on body parts
– prevent damage to superficial nerves and blood vessels
– prevent contractures
– maintain muscle tone

Support Devices
– pillows support or elevation of a body part
– mattresses standard or egg crate
– bed boards provide support and are placed under the mattress
– chair beds can be positioned as a chair
– foot boot maintains alignment of the feet
– footboard prevents plantar flexion of the foot

Fowler’s Position
– head of bed 15 to 45 degrees {low to semil} and 90 degrees {high}
– rest head against mattress or small pillow
– support forearms with pillows
– position pillow at lower back
– small pillow under thigh
– small pillow under lower legs

Dorsal Recumbent Position
– head and shoulders slightly elevated with a pillow
– small rolled towel under lumbar area of back
– trochanter rolls to prevent external rotation of legs
– elevate heels with small pillow under lower legs

Prone Position
– on abdomen
– head turned to one side and supported with pillow
– small pillow under abdomen
– arms flexed position level at shoulders
– lower legs supported with pillows

Lateral Position
– client lying on side
– upper knee and hip flexed
– pillow under head and neck
– upper arm flexed and supported with pillow
– other arm flexed and supported by mattress
– pillow behind back and under upper leg from groin to foot

Sims’ Position
– client is semiprone
– small pillow under head
– upper arm flexed with pillow to support
– upper leg flexed with pillow to support
– sandbag or roll to support feet in dorsal flexion

– spine stays straight and the whole body is moved at the same time
– requires 2-3 people, depending on situation
– cross client’s arms on chest
– place pillow between client’s knees
– turn as one unit on one nurse’s count
– place pillows behind head, back, and upper and lower extremities

ROM Exercises
– maintains or increases muscle strength and endurance
– improves or maintains joint mobility
– prevents deterioration of joints, ankylosis, and contractures
– increases circulation to affected areas

Active ROM
– client moves each joint through its complete range of motion
– client education on ROM exercises
—- perform systematically, use same sequence each time
—- perform three repetitions of each exercise
—- perform each series of exercises twice daily

Passive ROM
– exercises begin as soon as the ability to move the extremity or joint is lost
– carry out each movement slowly and to the point of resistance
– should not cause pain
– never force the joint beyond its capacity
– support the limb above and below the joint as needed
– nurse stands at the side of the bed closest to the joint being exercised
– use a head to toe sequence moving from larger to smaller joints

Transferring Clients
– maintain safety
– ask the client to assist as much as possible
– ensure client understanding
– determine client’s comfort level
– determine the safest way to move the client

Before Ambulating Assess:
– activity tolerance
– tolerance of upright position
– strength
– pain
– coordination
– balance
– environment

Getting Clients out of Bed
– move to the edge of the bed
– raise the head of the bed
– place bed in lowest position
– always dangle before making transfer or ambulation

Gait Belt
– two nurses stand on either side of client
– each holds one side of the gait belt and the lower aspect of the client’s upper arm
– document distance and duration of client’s ambulation

Crutches : Getting into a Chair
– unaffected leg against the chair
– transfer crutches to hand on affected side
– client grasps the arm of the chair with unaffected side
– lean forward, flex the knees and hips, and lower into the chair

Crutches : Getting out of a Chair
– move forward to the edge of the chair
– place the leg slightly under or at the edge of the chair
– grasp the crutches in hand on affected side
– grasp arm of chair by hand on unaffected side
– push down on crutches and chair
– assume tripod position before moving

Crutches : Going up Stairs
– assume the tripod position at bottom of stairs
– move unaffected leg onto step
– move crutches and affected leg up to the step

Crutches : Going down Stairs
– nurse stands one step below patient on affected side
– assume tripod position
– move crutches and affected leg down onto next step
– move unaffected leg to that step

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