The client's nursing diagnosis is "Impaired physical mobility manifested by paralysis of both lower extremities.". Which is the best intervention for the nurse to use to place the client in semi-Fowler's position?

Question

1. Help the client push up in bed by bending the client's knees.
2. Raise head of the bed to 45 degrees and pull client to head of bed.
3. Roll the client to one side using pillows to support the client's back.
4. Pull the client to head of the bed and then, raise the head of the bed.

Answer 1

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4. With the assistance of another staff member and using a draw sheet, the nurse bends the client's knees to unweight the legs, pulls the client to the head of the bed (HOB), elevates the HOB to 45 degrees, and removes wrinkles from the draw sheet. The client cannot assist with repositioning, so the nurse uses the help of another per-son, the draw sheet, synchronized movements, proper body mechanics, and un-weighting the legs to reduce the amount of force needed to move the client. Using these techniques, the nurse moves and repositions the client correctly to prevent skin breakdown and injury. If it is available, the client can assist positioning using an overhead trapeze to unweight the torso.
1. The client is unable to push up to the HOB because the client is paralyzed below the waist.
2. Elevating the HOB follows moving the client up in bed and minimizes the force needed to move the client uphill and decreases the risk of injury.
3. Rolling the client to the side achieves Sims' or lateral position, or assists with lo-grolling; however, rolling the client is usually necessary to place the draw sheet under the client before moving the client up in bed.