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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Concepts Covered:

  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Vascular Disorders
  • Emergency Care of the Trauma Patient
  • Cardiovascular
  • Circulatory System
  • Multisystem
  • Neurological
  • Urinary System
  • Fundamentals of Emergency Nursing
  • Prioritization
  • Test Taking Strategies
  • Medication Administration
  • Intraoperative Nursing
  • Postoperative Nursing
  • Microbiology
  • Upper GI Disorders
  • Understanding Society
  • Tissues and Glands
  • Adulthood Growth and Development
  • Adult
  • Basic
  • Pediatric
  • Pregnancy Risks

Study Plan Lessons

Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Dysrhythmias for Certified Emergency Nursing (CEN)
Heart Failure for Certified Emergency Nursing (CEN)
Hypertension for Certified Emergency Nursing (CEN)
Pericardial Tamponade for Certified Emergency Nursing (CEN)
Thromboembolic Disease- Deep Vein Thrombosis (DVT) for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
02.01 Hypertensive Crisis for CCRN Review
02.06 Heart Murmurs for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
02.18 Cardiovascular Practice Questions for CCRN Review
07.01 CVA (Cerebrovascular Accident/Stroke) for CCRN Review
EKG (ECG) Course Introduction
Electrical A&P of the Heart
Electrolytes Involved in Cardiac (Heart) Conduction
The EKG (ECG) Graph
EKG (ECG) Waveforms
Calculating Heart Rate
Normal Sinus Rhythm
Sinus Bradycardia
Sinus Tachycardia
Atrial Flutter
Atrial Fibrillation (A Fib)
Premature Atrial Contraction (PAC)
Supraventricular Tachycardia (SVT)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
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)
Emergency Nursing Course Introduction
Prioritizing Assessments
Triage in the ER
Critical Incident Management
Dysrhythmia Emergencies
Cardiopulmonary Arrest
Heart (Heart) Failure Exacerbation
Hypertensive Emergency
IV Insertion Course Introduction
Supplies Needed
Using Aseptic Technique
Selecting THE vein
Tips & Tricks
IV Catheter Selection (gauge, color)
Positioning
IV Insertion Angle
How to Secure an IV (chevron, transparent dressing)
Drawing Blood from the IV
Maintenance of the IV
IV Complications (infiltration, phlebitis, hematoma, extravasation, air embolism)
Needle Safety
IV Drip Therapy – Medications Used for Drips
IV Drip Administration & Safety Checks
Understanding All The IV Set Ports
Giving Medication Through An IV Set Port
How to Remove (discontinue) an IV
IV Placement Start To Finish (How to Start an IV)
Bariatric: IV Insertion
Dark Skin: IV Insertion
Tattoos IV Insertion
Geriatric: IV Insertion
Life Support Review Course Introduction
CPR-BLS (Basic Life Support)
Advanced Cardiovascular Life Support (ACLS)
Pediatric Advanced Life Support (PALS)
Cardiac Course Introduction
Cardiac A&P Module Intro
Cardiac Anatomy
Coronary Circulation
Heart (Cardiac) Sound Locations and Auscultation
Hemodynamics
Preload and Afterload
Performing Cardiac (Heart) Monitoring
Blood Flow Through The Heart
Acute Coronary Syndrome (ACS) Module Intro
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
MI Surgical Intervention
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Heart (Cardiac) Failure Module Intro
Nursing Care and Pathophysiology for Heart Failure (CHF)
Heart (Cardiac) Failure Therapeutic Management
Pacemakers
Cardiovascular Disorders (CVD) Module Intro
Nursing Care and Pathophysiology of Hypertension (HTN)
Nursing Care and Pathophysiology for Valve Disorders
Nursing Care and Pathophysiology for Cardiomyopathy
Nursing Care and Pathophysiology for Arterial Disorders
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Venous Disorders (Chronic venous insufficiency, Deep venous thrombosis/DVT)