Positioning

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Chance Reaves
MSN-Ed,RN
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Outline

Nursing Points

General

  1. Select the ideal vein
    1. This impacts all other positions
      1. Ex: Selecting a leg vein will mean you have to elevate the bed versus being able to place the arm in a bedside table.
    2. Place the extremity or position in the ideal location
      1. Elevating a foot will decrease optimal vein filling
      2. Dangle arms to improve blood flow
        1. Pumping the fist can help increase blood flow
  2. Patient comfort
    1. Select a position comfortable for the patient
    2. If they are uncomfortable, they are less likely to cooperate
      1. Ex: Sitting a patient upright after abdominal surgery may be uncomfortable
    3. Be mindful of patient needs
  3. Nursing ergonomics
    1. Raise the bed to the real working height
      1. If you’re not comfortable, the process will become even more frustrating
    2. If you can’t raise the bed, then sit
      1. Pull up a bedside chair and place the patient’s hand or leg so you can access it comfortably

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Transcript

In this lesson we’re going to talk about patient positioning as it relates to your IV placement. What you want to do is think about three things whenever you’re looking at your patient’s position. The first one is ideal site location. The second one is patient comfort, and the last one is nursing ergonomics. So let’s take a look at the first one. The first one is an ideal site selection. So what that means is if we’re putting in maybe a foot Ivy, we want to make sure that we put the foot in the best position, the most proper position, and the most optimal position to get that IV started. If I raise that foot up really high, it’s actually going to cause that Venus draining, so your the veins are going to be flat, they’re not going to pop up like you want them to. It’s going to make it more complicated.

It also is uncomfortable for the patient, so always think, take that into consideration. The second thing is patient comfort. You never want to put your patient in a compromising position where it could affect them health wise or something that’s uncomfortable. If they’re uncomfortable, they’re not going to be compliant. They’re going to wiggle. You’re going to have a more difficult time getting that IV set. So always put your patient in a very comfortable position. And the last one is nursing or ergonomics. And when I say nursing ergonomics, I’m talking about your safety. I’m talking about making sure that you are comfortable and that you are really doing things in an optimal position and optimal comfort for you. The last thing you want to do is have the bed in the lowest position. You’re trying to get a foot Ivy, and then all of a sudden your back hurts.

And for the rest of the day, you’re just aching. And you don’t want to do that. So what you need to do is you need to raise that bet up to the real working height. I’m a tall guy, I’ve always told my patients every time I’m raising them up in the bed, Hey, you’re going for a little ride, because that’s important for them to know that they’re going to be really high up in the air. But it’s for my safety as well. The other thing is if that’s not going to work for you, you can also put the patient’s bed in the lowest position and then bring that bedside chair over and have them dangle that arm over and you can get that IV, but that way. So always take these things into consideration when you’re looking at your patient’s position. Now, I hope these tips have really helped you out. Now, like we always say, go out and be your best selves today, and as always, happy nursing.

 

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NP4 exam1

Concepts Covered:

  • Circulatory System
  • Urinary System
  • Noninfectious Respiratory Disorder
  • Respiratory System
  • Integumentary Disorders
  • Respiratory Disorders
  • Labor Complications
  • Disorders of Pancreas
  • Pregnancy Risks
  • Cardiac Disorders
  • Eating Disorders
  • Respiratory Emergencies
  • Infectious Respiratory Disorder
  • Emergency Care of the Cardiac Patient
  • Vascular Disorders
  • Shock
  • Medication Administration
  • Upper GI Disorders
  • Fundamentals of Emergency Nursing
  • Understanding Society
  • Adulthood Growth and Development
  • Oncologic Disorders
  • Postoperative Nursing
  • Renal Disorders
  • Microbiology
  • Intraoperative Nursing
  • Shock
  • Tissues and Glands
  • Newborn Care

Study Plan Lessons

EKG (ECG) Course Introduction
Fluid & Electrolytes Course Introduction
Respiratory Course Introduction
Electrical A&P of the Heart
Respiratory A&P Module Intro
Electrolytes Involved in Cardiac (Heart) Conduction
Fluid Pressures
Lung Sounds
Alveoli & Atelectasis
Alveoli & Atelectasis
Fluid Shifts (Ascites) (Pleural Effusion)
Gas Exchange
Gas Exchange
Isotonic Solutions (IV solutions)
Hypotonic Solutions (IV solutions)
Hypertonic Solutions (IV solutions)
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Lung Diseases Module Intro
The EKG (ECG) Graph
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology for Asthma
EKG (ECG) Waveforms
Sodium-Na (Hypernatremia, Hyponatremia)
Calcium-Ca (Hypercalcemia, Hypocalcemia)
Calculating Heart Rate
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of COPD (Chronic Obstructive Pulmonary Disease)
Chloride-Cl (Hyperchloremia, Hypochloremia)
Restrictive Lung Diseases (Pulmonary Fibrosis, Neuromuscular Disorders)
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Nursing Care and Pathophysiology of Acute Respiratory Distress Syndrome (ARDS)
Nursing Care and Pathophysiology for Pulmonary Edema
Phosphorus-Phos
Normal Sinus Rhythm
Normal Sinus Rhythm
Respiratory Infections Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Influenza (Flu)
Sinus Bradycardia
Sinus Bradycardia
Sinus Tachycardia
Sinus Tachycardia
Nursing Care and Pathophysiology for Tuberculosis (TB)
Atrial Flutter
Pacemakers
Nursing Care and Pathophysiology of Pneumonia
Atrial Fibrillation (A Fib)
Atrial Fibrillation (A Fib)
Coronavirus (COVID-19) Nursing Care and General Information
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Ventricular Fibrillation (V Fib)
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Oxygen Delivery Module Intro
Hierarchy of O2 Delivery
Nursing Care and Pathophysiology of Hypertension (HTN)
Artificial Airways
Artificial Airways
Airway Suctioning
Airway Suctioning
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Respiratory Trauma Module Intro
Blunt Chest Trauma
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Chest Tube Management
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Pulmonary Embolism
Respiratory Procedures Module Intro
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABG Course (Arterial Blood Gas) Introduction
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acute Coronary Syndrome (ACS) Module Intro
Bariatric: IV Insertion
Base Excess & Deficit
Blood Flow Through The Heart
Bronchoscopy
Cardiac A&P Module Intro
Cardiac Anatomy
Cardiac Course Introduction
Cardiovascular Disorders (CVD) Module Intro
Chest Tube Management
Combative: IV Insertion
Coronary Circulation
Dark Skin: IV Insertion
Drawing Blood from the IV
Fluid Compartments
Geriatric: IV Insertion
Giving Medication Through An IV Set Port
Heart (Cardiac) Failure Module Intro
Heart (Cardiac) Failure Therapeutic Management
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Hemodynamics
How to Remove (discontinue) an IV
How to Secure an IV (chevron, transparent dressing)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
IV Catheter Selection (gauge, color)
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
IV Drip Administration & Safety Checks
IV Drip Therapy – Medications Used for Drips
IV Insertion Angle
IV Insertion Course Introduction
IV Placement Start To Finish (How to Start an IV)
Lactic Acid
Lung Sounds
Maintenance of the IV
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic Alkalosis
MI Surgical Intervention
Needle Safety
Nursing Care and Pathophysiology for Aortic Aneurysm
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Asthma
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Heart Failure (CHF)
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Influenza (Flu)
Nursing Care and Pathophysiology for Pneumothorax & Hemothorax
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Nursing Care and Pathophysiology for Tuberculosis (TB)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Nursing Care and Pathophysiology of Endocarditis and Pericarditis
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Nursing Care and Pathophysiology of Myocarditis
Nursing Care and Pathophysiology of Pneumonia
Pacemakers
Performing Cardiac (Heart) Monitoring
Positioning
Potassium-K (Hyperkalemia, Hypokalemia)
Preload and Afterload
Respiratory Acidosis (interpretation and nursing interventions)
Respiratory Alkalosis
ROME – ABG (Arterial Blood Gas) Interpretation
Selecting THE vein
Shock Module Intro
Supplies Needed
Tattoos IV Insertion
Thoracentesis
Tips & Tricks
Tips & Advice for Newborns (Neonatal IV Insertion)
Tips & Advice for Pediatric IV
Understanding All The IV Set Ports
Using Aseptic Technique
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)
Vent Alarms