Jennifer S.

Cruel, RN,MN
POSITIONING & DRAPING
POSITIONING - to place or arrange the
client to assume a certain
position for physical
examination or treatment
DRAPING - a piece of cloth placed
over a patients body
during an examination or
operation


GENERAL CONSIDERATIONS:
1. The method of draping vary with the
position of the patient, examination to be
done and temperature of the examination
room.
2. Draping should be arranged so as to avoid
all unnecessary exposure, but at the same
time not to interfere with a thorough
examination.

3. Draping should be loose enough to allow a
quick change of position but anchored
securely so as not to be displaced by
patients movement.
4. Methods of draping should be designed
with consideration for those who are
embarrassed by exposure of the body.
5. Draping should be warm whenever the
circumstances require it.

ERECT OR STANDING POSITION
the head and body is held in an upright
position

PURPOSE:
1. For vaginal examination - to determine
the presence of prolapse
uterus
2. For orthopedic condition


PROCEDURE:
1. Assist patient to stand and put his slippers
if floor is not covered.
2. Place a chair near one side where hand of
patient can rest for support.
3. For vaginal examination, elevate one foot
on a low stool.
4. Raise gown upward exposing only the area
to be examined.

HORIZONTAL RECUMBENT / SUPINE OR
DORSAL POSITION
Position in which the patient lies flat on the
back, with the head and shoulders also flat on
the bed

PURPOSE:
1. General physical examination
2. Various operative procedures
3. For comfort by providing a change in position


PROCEDURE:
1. Have the patient lie on his back with the
legs extended or slightly flexed.
2. Place pillow under the head and another
smaller one under the knees for support.
3. Arms be crossed on the chest or lie loosely
at the sides of the body.
4. Put the sheet over the patient covering the
body completely from the neck to shoulders
downward without tucking it under the
mattress.

DORSAL RECUMBENT POSITION
the patient lies flat on the back with head and
shoulders slightly elevated on a small pillow

PURPOSE:
1. Vaginal examination
2. Digital rectal examination (DRE)
3. Pelvic examination
4. For catheterization


PROCEDURE:
1. Assist patient to lie flat on his back.
2. Separate the legs, flex the thighs so that the
soles of the feet rest on the bed.
3. Place the arms either above the head or flex
with the hands on the chest.
4. Place one pillow under the head.
5. Bring buttocks of the patient to the edge of
the bed.



6. Drape with two sheets placed over the body
or with one sheet diagonally.
7. Place a sterile towel under the buttocks and
brings the ends up to cover the vulva while
waiting for the physician.

DORSAL LITHOTOMY POSITION
back lying position with lower legs raised and
supported by stirrups

PURPOSE:
1. For cystoscopic examination
2. For vaginal delivery
3. For operations and examinations on the
perineum, vagina, cervix, bladder and rectum

PROCEDURE:
1. Assist client to lie on her back.
2. Separate the legs and flexes the thighs deeply
toward the abdomen. Elevates the lower legs
and support them with stirrups.
3. Bring the buttocks to the edge of the table or
a little beyond.
4. Raise the arms above the head or flexes them
with the hands on the chest.
5. Draping is the same as in dorsal recumbent
position. Cover the vulva with towel in the
same manner.

PRONE POSITION - the patient lies on the
abdomen with the head
turned to one side

PURPOSE:
1. Promotes drainage from the mouth
2. Useful for unconscious clients or those
recovering from surgery of the mouth or
throat

PROCEDURE:
1. Help the patient to assume the horizontal
recumbent position.
2. Assist him or her to turn over onto the
abdomen.
3. Turns the head to one side.
4. Place arms at the sides or extends upwards.
5. Place a small pillow beneath the wrist and a
large one under the legs if patient has to stay
in the position for a long time.
6. Draping is similar to that of the dorsal
position.


TRENDELENBURG POSITION
the head and body are lowered

PURPOSE:
1. Used for surgery on the lower abdomen and
pelvis
2. For treatment of shock or decreased blood
pressure

PROCEDURE:
1. Place the patient on his back.
2. Elevate the foot of the bed so that legs extend
upward at 45 degrees angle. Head and
shoulders are lower that the hips and legs.
3. Draping depends upon the kind of operation
to be performed and or similar to that of the
horizontal recumbent position.


FOWLERS POSITION
the patient is semi-sitting with the head and
trunk elevated 45 to 90 degrees

PURPOSE:
1. Promoting cardiac and respiratory function
2. To relieve dyspnea
3. To facilitate drainage after surgery


PROCEDURE:
1. Place the patient in horizontal recumbent
position.
2. Elevate the head of the bed to
approximately 45 degrees angle.
3. Flex the knees slightly and support them
with knee rolls.
4. Drape as in horizontal recumbent position.


SIMS POSITION - the patient lies on one
side of the body

PURPOSE:
1. For resting sleeping
2. For unconscious clients
3. Used for paralyzed patient

PROCEDURE:
1. Assist the patient to lie on either side,
preferably the left with the body inclined
forward.
2. Extend the left arm behind the back and flex
the elbow of the right arm forward.
3. Flex the right thigh towards the abdomen
with the knees drawn up higher that the left
knee which is only slightly flexed.
4. Lay out the draping sheet as in horizontal
position. Fold back or gather a side of the
sheet to expose the area to be examined.



JACKNIFE POSITION - back lying
position with both legs
raised perpendicularly

PURPOSE:
1. For rectal surgery
2. For cystoscopic examination

PROCEDURE:
1. Let the patient lie on his or her back with
shoulders slightly elevated.
2. Bring thighs up to form a right angle with
the anterior part of the trunk and knees
flexed so that the lower legs rest against the
thighs.
3. Draping depends on the operation to be
performed since this position is more for
surgery rather that for examination.

KNEE-CHEST POSITION - patient lies on
the abdomen with knees
slightly separated on a
kneeling position and chest
resting on the bed.

PURPOSE:
1. For rectal examination and surgery

PROCEDURE:
1. Place the patient in prone position.
2. Assist to kneel with the knees slightly
separated.
3. Bend forward so that the chest is resting on
the bed.
4. Turns the head to one side, extends hands
over head or flex at the elbows.
5. Be sure thighs are perpendicular.
6. Expose part to be examined only.

ORTHOPNEIC POSITION
the patient sits either in bed or on the side
of the bed with an overbed table across the
lap

PURPOSE:
1. Facilitates respiration
2. For clients who have problems exhaling


PROCEDURE:
1. Have patient sit up on bed.
2. Place overbed table across the lap.
3. Pad table with pillows and elevate to
comfortable height.
4. Let patient lean forward with head and
arms resting on table.
5. Cover with top sheet from waist downward.