Body Posture & Lifting-8

8/9/2019 Body Posture & Lifting-8

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NSK 1114

NURSING SKILL I

NOORSALFIZAH BINTI JAMIL


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POSTURE, BODY

MECHANICS AND

MOBILITY OF CLIENT ANDCAREGIVER


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NORMAL MOVEMENT

Equilibrium is a normal movement and

stability that are intact with:

1. Musculoskeletal system.2. Nervous system.

3. Inner ear structures.


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Normal movement (cont)..

Body movement required coordinated

muscle activity and neurologic integration.

It involves four basic elements:Body alignment (posture)

Joint mobility

Balance

Coordinated movement


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JOINT MOBILITY

Refers to the persons ability to move

freely.

Serves many purpose, such as expansionof an emotion with a nonverbal gesture,

self defense, satisfaction of basic needs

and performance of Activity of Daily Living

(ADLs) and recreational activities.


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Joint mobility (cont)..

Many function of the body need mobility to

function optimally. To maintain optimal

physical mobility, the musculoskeletal andnervous systems of the body must be

intact and functioning.


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IMMOBILITY

Refer to inability to move freely.


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ALIGNMENT AND POSTURE

Proper body alignment and posture bring

body part into position in a manner that

promotes optimal balance and maximal

body function (sitting, standing or lying

down)

A person maintains balance as long as the

line of gravity passes through the center ofgravity and the base of support.


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Alignment and posture (cont)..

In human, the usual line of gravity begins

at the top of the head and falls between

the shoulders, through the trunk, slightly

anterior to the sacrum and between the

weight-bearing joints and base of support.


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When body is well aligned, strain on the

joints, muscles, tendons or ligaments is

minimized and internal structures and

organ are supported.


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A persons posture is one criterion for

assessing general health, physical fitness

and attractiveness.

Posture reflects the mood, self-esteem

and personality of an individual.


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JOINT MOBILITY

Are the functional units of the

musculoskeletal systems.

The bones of the skeletal articulate at thejoints and attach to the two bones at the

joint.


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The muscles are categorized according to

the type of joint movement they produce

on contraction.

Muscles are called flexors, extensors, internal

rotators.

The flexor muscles are stronger than the

extensor muscles.


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When a person inactive, the joints are pulled

into a flexed (bent) position. If this tendency is

not countered with exercise and position

changes the muscle permanently shorten andthe joint becomes fixed in a flexed position

(contracture)


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Types of joints


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Range of motion (ROM) is the maximum

movement that is possible for that joint.


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BALANCE

Mechanisms involved in maintaining

posture are complex and involve

informational inputs from the inner ear,

from vision and from stretch receptors of

muscles and tendons.

Mechanisms equilibrium (sense of

balance) respond, frequently without orawareness to various head movements.


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Balance (cont)..

Under normal conditions the equilibrium

receptors in the semicircular canals and

vestibule, collectively called the vestibular

apparatus, send signals to the brain that

initiate reflexes needed to make required

changes in position.

The receptors, hair like cells, respond todisplacement of the head in any direction.


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Balance (cont)..

When the head moves, the fluid flow within

the vestibule and semicircular canals

stimulates sensory hair cells.

Information from these balance receptors

goes directly to reflect centers in the brain

stem. This enables fast reflexive

responses to body imbalance.


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COORDINATED MOVEMENT

The cerebellum coordinates the motor

activities of movements and basal ganglia

maintain the posture.

When a clients cerebellum is injured,

movement become clumsy, unsure and

uncoordinated.


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BODY MECHANICS

Is the term used to describe the efficient,coordinated and safe use of the body tomore objects and carry out the activities of

daily living.Using principles of body mechanics during

routine activity will prevent injury.

The nurse teaches a colleagues andclients families to lift, transfer or positionclients properly.


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PATHOLOGICAL INFLUENCES

ON BODY MECHANICS

For example:

Congenital defects (disorders of bones, joints

and muscles- Osteoporosis)

Central nervous system damage

Musculoskeletal trauma- bruises, confusions,

sprain and fracture.


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PRINCIPLE OF BODY

MECHANICS

The wider the base of support , the greater

the stability of the nurse.

The lower the center of gravity, the greaterthe stability of the nurse.

The equilibrium of the subject is

maintained as long as the line of gravity

passes through its base of support.


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Principle of body mechanic (cont)..

Facing the direction of movement prevents

abnormal twisting of the spine.

Dividing balance activity between armsand legs reduces the risk of back injury

Rolling, turning or pivoting requires less

work than lifting.


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Principle of body mechanic (cont)..

When friction is reduced between theobject to move and the surface on which itis moved, less force is required to move it.

Reducing the force of work reduce the riskof injury.

Maintaining good body mechanics reduce

fatigue of muscle groups.Alternating period of rest and activity helps

to reduce fatigue.


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LIFTING

Nurse should not lift more than 51 lbs

without assistance from proper equipment

and/ or other persons.

When a person lift or carries an object, the

weight of the object becomes part of the

persons body weight affects the location

of the persons center of gravity


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Lifting (cont)..

To counteracts this potential imbalance,

body parts (e.g. arm & trunk) move in a

direction away from the weight center of

gravity is maintained over the base of

support.

Holding the lifted objects as close possible to

the body avoids undue displacement of thecenter of gravity and achieves greater

gravity.


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Lifting (cont)..

Lifting involves movement against gravity.

The nurse must use the major group of the

thighs, knees, upper and lower arms,abdomen and pelvis to prevent back

strain.


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PULLING AND PUSHING

When pulling and pushing an object, a

person maintains balance with least effort

when the base of support is enlarged in

the direction in which the movement is to

be produced or opposed.


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PIVOTING

Is a technique in which the body is turned

in way that avoids twisting of spine (turn

90 degree in the desired direction )


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PREVENTING BACK INJURY

The major contributor is habitually poor

standing and sitting posture lordosis.

Overweight individuals who carry theirextra weight over their abdomen, pregnant

women and women who consistently wear

high-healed shoes are at risk

exaggerated lumbar.


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POSTURE, BODY MECHANICS

AND MOBILITY OF CLIENT AND

CAREGIVER (PROCEDURE)

MOVING / LIFTING


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MOVING IMMOBILITY CLIENT UP

IN BED (ONE NURSE)

Place client on back with head of bed flat.

Stand one side of bed.Remove pillow from under head and

shoulders and place pillow at head of bed


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Moving immobility client up in bed (cont)..

Begin at client feet. Face foot of bed at 45

degree angle. Place feet apart with foot

nearest head of bed behind other foot

(forward-backward stance). Flex knees

and hips as needed to bring arms level

with clients legs. Shift weight from front to

back leg and slide clients legs diagonallytoward head of bed.


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Move parallel to clients hips. Flex knees

and hips as needed to bring arms level

with clients hips.

Slide clients hip diagonally toward head of

bed.

Move parallel to clients head and

shoulders. Flex knees and hips as neededto bring arms level with clients body.


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Slide arms closest to head of bed under

clients beck with hand reaching under and

supporting clients opposite shoulder.

Place other arm under clients upper back.

Slide clients trunk, shoulders, head and

neck diagonally toward head of bed.

Elevate side rail.


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AUSTRALIAN LIFT

ASSIST CLIENT IN MOVING UP IN


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ASSIST CLIENT IN MOVING UP IN

BED (ONE OR TWO NURSES)-

AUSTRALIAN LIFT.

Remove pillow from under head andshoulders and place pillow at head of bed.


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Assist client in moving up in bed (cont)..

Face head of bed

Each nurse should have one arm under clientsshoulder and one arm under clients thighs.

Alternative position; one nurse clients upperbody. Nurses arm nearest head of bed shouldunder clients head and opposite shoulder; otherarms should under clients closest arm andshoulder. Position other nurse at clients lowertorso. The nurses arm should be under clientslower back and torso.


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Place feet apart, with foot nearest head of

bed behind other foot.

When possible, ask client to flex knees

with feet flat on bed.

Instruct client to flex neck, tilting chin

toward chest.


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Instruct client to assist moving by pushing

with feet on bed surface.

Flex knees and hips, bringing forearms

closer to level of bed.


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Instruct client to push with heels and

elevate trunk while breathing out, thus

moving towards head of bed on count of

three.

On count of three, rock and shift weight

from front to back leg. At the same time

client pushes with heels and elevatestrunk.


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MOVE WITH DRAWSHEET

MOVE IMMOBILE CLIENT UP IN BED


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MOVE IMMOBILE CLIENT UP IN BED

WITH DRAWSHEET OR PULL SHEET

(TWO NURSES)

Place drawsheet or pull sheet under client

by turning side to side. Have sheet extend

from shoulders to thighs. Return client to

supine position.

Position one nurse at each side of client.


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Move immobile client up in bed with

drawsheet or pull sheet (cont)..

Grasp drawsheet or pull sheet firmly near

the client.

Place feet apart with forward-backward

stance. Flex knees and hips. Shift weight

from front to back leg and move client and

drawsheet or pull sheet to desired position

in bed.Realign client in correct body alignment.

LOGROLLING THE CLIENT


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(THREE NURSES)

Place pillow between clients knees.

Cross clients arms on chest.

Position two nurse on side to which the

client will be turned.P

osition third nurseon the other side of bed.


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Logrolling the client (cont)..

Fanfold or roll the drawsheet or pull sheet.

Move the client as one unit in a smooth,

continuous motion on the count of three.


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Logrolling the client (cont)..

Nurse on the opposite side of bed places

pillows along the length of the client.

Gently lean the client as a unit back

towards the pillows for support.


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ASSIST TO SITTING POSITION


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ASSIST TO SITTING

POSITION


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Assist to sitting position (cont)..

Place client in supine position.

Face head of bed at a 45 degree angleand move pillows.

Place feet apart with foot nearer bedbehind other foot, continuing 45 degreeangle to head of the bed.

Place hand further from client undershoulders, supporting clients head andcervical vertebrae.


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Assist to sitting position (cont)..

Place other hand on bed surface.

Raise client to sitting position by shifting

weight from front to back leg.

Push against bed using arm that is placed

on bed surface.


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SIT ON SIDEOF BED


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ASSIST TO SIT ON SIDE OF

BED


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Assist to sit on side of bed (cont)..

Turn client to side, facing you on side of

bed on which client will be sitting.

With client in supine position, raise head of

bed 30 degrees.

Stand opposite clients hips. Turn

diagonally so you face client and far

corner of foot of bed.


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Place feet apart with foot closer to head of

bed in front of other foot.

Place arm nearer head of bed under

clients shoulder supporting head and

neck.

Place other arm over clients thighs.


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Move clients lower legs and feet over side

of bed. Pivot toward rear legs, allowing

clients upper legs to swing downward.

At same time, shift weight to rear leg and

elevate client.


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TRANSFERRING FROM

BED TO

CHAIR


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Transferring for bed to chair (cont)..

Assist client to sitting position on side of

bed. Have chair in position at 45 degree

angle to bed.

Apply transfer belt or other transfer aids.

Ensure the client has stable nonskid

shoes. Weight-bearing or strong leg is

place forward, with weak foot back.


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Spread feet apart.

Flex hips and knees, aligning knees with

clients knees.

Grasp transfer belt from underneath.

Rock client up to standing position on

count of three while straightening hips and

legs and keeping knees slightly flexed.


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Maintain stability of clients weak or

paralyzed leg with knee.

Pivot on foot farther from chair.

Instruct client to use arm rest on chair forsupport and ease into chair.


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Flex hips and knees while lowering clientinto chair.

Assess client for proper alignment forsitting position. Provide support forparalyzed extremities.

Praise clients progress effort orperformance.


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THREEMAN LIFT


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THREE-P

ERSON ( THREE MAN LIFT )CARRY FROM BED TO

STRETCHER

Th ( th lift ) f


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Three- person ( three man lift ) carry from

bed to stretcher (cont)..

Three nurses stand side by facing side of

clients bed.

Each person assumes responsibility for

one of three area; head and shoulder, hips

and thighs and ankles.

Each person assumes wide base of

support with foot closer to stretcher in frontand knees slightly flexed.

Th ( th lift ) f


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Arms of lifters are placed under clients head

and shoulder, hips and thighs and ankles with

fingers securely around other side of clients

body.Lifters roll client toward their chest. On count of

three, client is lifted and held against nurses.

On second count of three, nurses step back and

pivot towards stretcher, moving forward ifneeded.

Th ( th lift ) f


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Gently lower client onto center of stretcher

by flexing knees and hips until elbows are

level with edge of stretcher.

Assess clients body alignment, place

safety straps across body and raise side

rails.


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THANK YOU

Body Posture & Lifting-8

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