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PROCEDURE 10-11: Demonstrate Patient Positions Used in a Medical Examination

Theory and Rationale

When positioning the patient, some factors to be considered are the patient’s range of motion, the patient’s comfort, and the length of time the position will be maintained.You should not place the patient in any position other than sitting or lying until the examination or procedure is ready to begin. Children and the elderly should never be left alone. The patient should be covered with a drape that is lifted only when the body part is being examined. Depending on the type of examination, the physician will have the patient shift from a sitting position to other positions. For a pelvic examination and Pap smear, the patient is moved from sitting to supine, then dorsal recumbent, and last to the lithotomy position. A patient experiencing shortness of breath should be placed in a Fowler’s position to facilitate breathing. As you may not be present for the entire examination, it is important that you anticipate draping and positioning needs based on the patient’s reason for visiting the medical office.

Materials

Competency

(Conditions) With the necessary supplies, (Task) you will be able to assist the patient into the sitting, supine, Sims’, prone, dorsal recumbent, lithotomy, Fowler’s, semi-Fowler’s, and Knee-chest positions (Standards) correctly within the time frame designated by the instructor.

  1. Identify the patient and escort to examination room.
  2. Wash your hands and gather drape materials.
  3. Explain the procedure to the patient. Ask the patient to completely undress and to put on a patient gown. For a breast examination, instruct the patient to tie the gown in front.
  4. Instruct the patient to sit on the examination table, assisting as necessary. Cover the patient with the drape.
  5. Assist the patient into the Fowler’s position.
  6. Assist the patient into the semi-Fowler’s position.
  7. Assist the patient into the supine position.
  8. Assist the patient into the dorsal recumbent position.
  9. Assist the patient into the lithotomy position.
  10. Assist the patient back into the supine position, then into the prone position.
  11. Assist the patient into the Sims’ position.
  12. Assist the patient into the knee-chest position.
  13. Assist the patient into the sitting position and stepping off the examination table.
  14. After the examination has been completed and the physician has discussed the procedure with the patient, clean the examination room. Remove the used paper from the examination table and replace it with clean paper for the next patient.
  15. Wash your hands and complete documentation in the patient’s chart.

Patient Education

Explain to the patient that he or she will be assisted/directed through change of positions for the examination. Provide reassurance that modesty will be provided. Inform patient that some discomfort may be experienced, but encourage patient to verbalize any additional needs that may need to be addressed throughout the examination.

Charting Example

12/05/XX 9:30 AM Assisted patient turning from supine to left-lateral position for rectal examination. Patient tolerated examination without discomfort. Danica Verdo, RMA (AMT)






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