Fundamentals of Nursing Q 332

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The nurse must examine a patient who is weak and unable to sit unaided or to get out of bed. How should she position the patient to begin and perform most of the physical examination?

  

     A. Dorsal recumbent

     B. Semi-Fowler's

     C. Lithotomy

     D. Sims'

    

    

Correct Answer: B. Semi-Fowler’s

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If a patient is unable to sit up, the nurse should place him lying flat on his back, with the head of the bed elevated. The Semi-Fowler’s position is a position in which a patient, typically in a hospital or nursing home is positioned on their back with the head and trunk raised to between 15 and 45 degrees, although 30 degrees is the most frequently used bed angle.

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Option A: Dorsal recumbent position is used for abdominal assessment if the patient has abdominal or pelvic pain. The patient in dorsal recumbent is on his back with knees flexed and soles of feet flat on the bed.

Option C: Lithotomy position is used for female pelvic examination. It is similar to dorsal recumbent position, except that the patient’s legs are well separated and thighs are acutely flexed. Feet are usually placed in stirrups. Fold sheet or bath blanket crosswise over thighs and legs so that genital area is easily exposed. Keep the patient covered as much as possible.

Option D: The patient in Sim’s position is on the left side with right knee flexed against abdomen and left knee slightly flexed. Left arm is behind the body; the right arm is placed comfortably. Sims’ position is used to examine the rectal area. In semi-Fowler’s position, the patient is supine with the head of the bed elevated and legs slightly elevated.

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