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Chapter 15
Body Mechanics and Patient
Mobility
Jeanelle F. Jimenez RN, BSN, CCRN
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Using Appropriate Body
Mechanics
• Body Mechanics

Field of physiology that studies muscular action and
the function of muscles in maintaining the posture of
the body
• The musculoskeletal system must be protected to
prevent injury to the patient and the nurse.





Maintain a wide base of support.
Bend the knees and hips rather than the back.
Stand in front of the object.
Adjust the working level to one of comfort.
Carry objects close to the midline of the body.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 2
Figure 15-1
(From Potter, P.A., Perry, A.G. [2005]. Fundamentals of nursing. [6th ed.]. St. Louis: Mosby.)
Good position for body mechanics.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 3
Figure 15-2
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
Picking up a box using good body mechanics.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 4
Positioning Patients
• There are many positions to use to prevent patients
from developing complications.

Dorsal (supine)
• Lying horizontally on the back

Dorsal recumbent
• Supine position with patient lying on back, head, and
shoulders, with extremities moderately flexed, legs may
be extended

Fowler’s
• Head of bed raised 45 to 60 degrees

Semi-Fowler’s
• Head of bed raised approximately 30 degrees
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 5
Skill 15-1: Step 9a
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 6
Skill 15-1: Step 9c
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 7
Skill 15-1: Steps 9e, 9f
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 8
Skill 15-1: Step 9g
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 9
Skill 15-1: Step 9h
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 10
Skill 15-1: Step 9i
(From Seidel, H.M., Ball, J.W., Dains, J.E., Benedict, G.W. [2003]. Mosby’s guide to physical
examination. [5th ed.]. St. Louis: Mosby.)
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 11
Skill 15-1: Step 9j
Positioning patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 12
Mobility versus Immobility
• Mobility

A person’s ability to move around freely in his or her
environment
• Serves Many Purposes

Express emotion
 Self-defense
 Attain basic needs
 Perform recreational activities
 Perform activities of daily living (ADLs)
 Maintain body’s normal physiological activities
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 13
Mobility versus Immobility
• Immobility

Inability to move around freely
• Complications of Immobility







Muscle and bone atrophy; contractures; pressure
ulcer
Constipation; urinary tract infection
Disuse osteoporosis; kidney stones
Pneumonia; pulmonary embolism; postural
hypotension
Anorexia; insomnia
Asthenia (weakness)
Disorientation
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 14
Figure 15-3
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Trochanter roll.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 15
Figure 15-4
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Hand roll.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 16
Performing Range-of-Motion
Exercises
• Range-of-Motion (ROM)

Any body action involving the muscles and joints in
natural directional movements
• Exercises may be performed by physical therapy
department personnel or by the nurse and allied
staff.
• Exercises are indicated for patients confined to bed
for long periods.
• Exercises may be performed passively by nurses or
actively by patients.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 17
Performing Range-of-Motion
Exercises
• The total amount of activity required to prevent
physical disuse syndrome is only about 2 hours for
every 24-hour period.
• Designated body joints are moved to the point of
resistance or pain, using care to avoid injury.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 18
Skill 15-2: Step 8
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Performing range-of-motion exercises.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 19
CMS Assessment
• Table 15-3
• Compartment Syndrome “6 P’s”






Pain, not relieved
Paresthesias
Pallor
Pulse absent (pulselessness)
Paralysis
Palpated tense tissue
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 20
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 21
Moving the Patient
• Moving includes lifting the patient up into bed, to the
side of the bed, to the tub, and into a car.
• Moving also includes turning, dangling, and assisting
the patient in and out of the bed for ambulation.
• Mechanical Equipment for Lifting Patients



Hydraulic lift
Roller board
Gurney lift
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 22
Figure 15-5
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Patient using a trapeze bar.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 23
Figure 15-6, A-C
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
A, The lift is over the patient. B, The sling is attached to a swivel bar.
C, The lift is raised until the sling and patient are off of the bed.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 24
Figure 15-6, D-E
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
D, The patient’s legs are supported as the patient and lift are moved
away from the bed. E, The patient is guided into a chair.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 25
Moving the Patient
• Lift twice

Once mentally and then once physically
• Be certain to have sufficient assistance.
• Assess patient’s ability to assist with moving.
• If moving may be painful for the patient, the nurse
will want to administer medication to the patient
before any such activity.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 26
Skill 15-3: Steps 9g(2), 9g(4)
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
Moving the patient.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 27
Skill 15-3: Step 12e
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
Moving the patient.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 28
Skill 15-3: Steps 13c, 13f
(From Potter, P.A., Perry, A.G. [2003]. Basic nursing: Essentials for practice. [5th ed.]. St. Louis: Mosby.)
Moving the patient.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 29
Skill 15-3: Step 13j(7)
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
Moving the patient.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 30
Skill 15-3: Step 13j(8)
(From Sorrentino, S.A. [2004]. Assisting with patient care. [2nd ed.]. St. Louis: Mosby.)
Moving the patient.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 31
Skill 15-3: Step 14f
(From Elkin, M.K., Perry, A.G., Potter, P.A. [2004]. Nursing interventions and clinical skills. [3rd ed.].
St. Louis: Mosby.)
Moving the patient.
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 32
Using the Lift for Moving Patients
• Mechanical devices, such as the hydraulic lift used
with a Hoyer sling, will

Move patients safely

Protect the nurse’s back

Provide full-weight lifting of patients who cannot assist
Mosby items and derived items © 2011, 2006, 2003, 1999, 1995, 1991 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 33
Fly UP