The patient is immobile and has been repositioned in bed using a drawsheet. When finished, the patient is in a supported Fowler's position with the head of the bed elevated 45 degrees. Also important for positioning this patient is to:

Question

a. support his calves with pillows.
b. place a large pillow behind his head to prevent extension.
c. place a pillow behind his upper back.
d. avoid using pillows if the patient does not have use of the hands and arms.

Answer 1

A
Support the calves with pillows. Heels should not be in contact with the bed to prevent prolonged pressure of the mattress on the heels. This sometimes is referred to as "floating" heels. Rest the patient's head against the mattress or on a small pillow. This prevents flexion contractures of the cervical vertebrae. A pillow behind the upper back would put the torso out of alignment. Position a pillow at the lower back to support the lumbar vertebrae and decrease flexion of the vertebrae. Use pillows to support the arms and hands if the patient does not have voluntary control or use of the hands and arms. This prevents shoulder dislocation from the effect of downward pull of unsupported arms, promotes circulation by preventing venous pooling, and prevents flexion contractures of arms and wrists.