Client Positioning for Examination and Treatment

1. Horizontal Recumbent Position
This position is required for most of the physical examinations. The client lies on the back with the legs extended. The arms are placed, folded on the chest, or along side the body. One small pillow may be used. Cover the client with bath blanket for privacy. Caution: This position may be uncomfortable for a person with a back problem

2. Dorsal recumbent position
used for variety of examinations and procedures. The client lies on the back, with the knees flexed and the soles of the feet flat on the bed. Cover the client with a sheet or a bath blanket folded once across the chest. The second sheet should be cross wise over the client thighs and legs. Wrap the lower ends of this sheet around the client’s legs and feet. Fold the sheet so the genital area is easily exposed. Keep the client covered as much as possible

3. Prone Position
is used to examine the spine and back. The client lies on the abdomen with head turned to the side for comfort. The arms are held above the head or along side the body. Cover the client with a bath blanket for privacy. Caution: Unconscious clients, pregnant women, clients with abdominal incisions, and clients with breathing difficulties cannot lie in this position.

4. Sims’ Position:
This position is used for rectal examination. The client rests on the left side, usually with a small pillow under the head. The right knee is flexed against the abdomen, the left knee is flexed slightly, the left arm is behind the body, and the right arm is in a comfortable position. Cover the client with a bath blanket.
Caution: The client with leg injuries or arthritis often cannot assume this position

5. Fowler’s Position:
this position is used to promote drainage or to make breathing easier. Adjust the head rest to the desired height, and raise the bed section (Gatch bed) under the client’s knees. Place a rolled pillow between the client’s feet and use the foot of the bed as a brace, if desired. Caution: Observe for signs of dizziness or faintness when you raise the head of the bed.

6. Knee-chest Position:
is used for rectal and vaginal examinations and as treatment to bring the uterus into normal position. The client is on the knees with the chest resting on the bed and the elbow rested on the bed, or with the arms above the head, the client’s head is turned to the side. The thighs are straight up and down, and the lower legs are flat on the bed. Caution: The client may become dizzy or faint and fall. Do not leave the client alone.

7. Dorsal Lithotomy Position:
is used for examination of pelvic organs. It is similar to dorsal recumbent position, except that the client’s legs are well separated and the knees are a cutely flexed. The nurse will usually place the client’s feet in stirrups. Keep the client covered as much as possible for privacy.