POSITIONING CLIENTS

🩺 Clinical Positioning Guide

Patient Positioning Guidelines by Condition, Procedure, and Examination

• Asthma/COPD exacerbation — High Fowler's position (60-90°), leaning forward with arms supported.
• Pulmonary Edema — High Fowler's with legs dependent.
• Pneumonia — Semi-Fowler's to maximize lung expansion.
• Post Bronchoscopy — Flat with head hyperextended.
• Postural Drainage — Affected lung segment uppermost.
• Air/Pulmonary Embolism — Left lateral decubitus with head down.
• Epistaxis — Sit upright, lean forward.

• Cerebral Aneurysm / Increased ICP — High Fowler's (30-45°), head neutral.
• Hemorrhagic Stroke — HOB elevated 30°.
• Ischemic Stroke — HOB flat.
• Head Injury — HOB elevated 30°, head midline.
• Post Lumbar Puncture — Lie flat (supine) 4-8 hrs.
• Post Supratentorial Surgery — HOB 30-45°.
• Post Infratentorial Surgery — Flat, lateral position.

• Thoracentesis — Sitting leaning over table or lying on unaffected side.
• Paracentesis — Supine or semi-Fowler's.
• Lumbar Puncture — Lateral recumbent with knees flexed or sitting leaning forward.
• Enema Administration — Left lateral Sims position.
• NG Tube Insertion — High Fowler's with neck flexed.
• Central Line Insertion — Trendelenburg position.
• Bronchoscopy — Supine with head hyperextended.

• Above Knee Amputation — Elevate residual limb, prone positioning daily.
• Below Knee Amputation — Elevate residual limb, avoid flexion.
• Post Thyroidectomy — Low/Semi-Fowler's, support neck.
• Total Hip Replacement — HOB ≤45°, maintain abduction.
• Hemorrhoidectomy — Side-lying position.
• Appendectomy — Fowler's position.
• Abdominal Surgery — Low Fowler's with knees flexed.

• Supine Position — For abdominal, cardiac, thoracic surgeries.
• Trendelenburg — Head lowered 15-30° for pelvic surgeries.
• Reverse Trendelenburg — Head elevated for upper abdominal surgery.
• Lithotomy Position — For gynecological, urological procedures.
• Prone Position — For spinal, posterior cranial surgeries.
• Lateral Position — For thoracic, renal, hip surgeries.

• Supine Position — For abdominal, breast exams.
• Dorsal Recumbent — For vaginal, rectal exams.
• Lithotomy Position — For gynecological exams.
• Sims Position — For rectal exams, enemas.
• Prone Position — For back, posterior thorax exams.
• Fowler's Position — For respiratory, cardiac assessments.

• Tube Feeding (↓LOC) — Right side lying, HOB elevated 30-45°.
• Hiatal Hernia/GERD — Upright during/after meals.
• Dumping Syndrome — Eat reclining, lie down after meals.
• Enema Administration — Left-side lying (Sim's position).
• Bowel Obstruction — Fowler's position.

• Cardiac Catheterization — Keep extremity straight.
• Myocardial Infarction — Semi-Fowler's position.
• CHF — High Fowler's with legs dependent.
• Hypovolemic Shock — Modified Trendelenburg.
• Pericarditis — Sit upright and lean forward.

• Prolapsed Cord — Knee-chest or Trendelenburg.
• Placenta Previa — Side-lying position.
• Supine Hypotensive Syndrome — Left lateral position.
• Pelvic Exam — Lithotomy position.
• Epidural Anesthesia — Lateral with knees to chest.

Based on standard nursing textbooks and clinical guidelines. For educational purposes only.

Always follow your facility's specific protocols and provider orders.