1.

Autograft: After surgery, the site is immobilized

2. Burns of the face and head: Elevate the head of

the bed
3. Circumferential burns of the extremities: Elevate

the extremities above

4. Skin graft: Elevate and immobilize the graft site
5. Mastectomy semi-Fowler’s position
6. Perineal and vaginal procedures: lithotomy position
7. Hypophysectomy: Elevate the head of the bed to

prevent increased intracranial pressure.

8. Thyroidectomy -semi-Fowler’s to Fowler’s
position[Avoid neck extension to decrease tension
on the suture line]
9. Hemorrhoidectomy: lateral (side-lying) position
10. Paracentesis: semiFowler’s position or sitting
upright
11. Nasogastric tube

a. Insertion:- high Fowler’s position with the head

tilted forward.
b. Irrigations and tube feedings :- semiFowler’s to
Fowler’s position
12. Rectal enema and irrigations: left Sims’ position
13. Sengstaken-Blakemore and Minnesota tubes :
elevation of the head of the bed
14. Chronic obstructive pulmonary disease: sitting

position, leaning forward,

15. Laryngectomy (radical neck dissection):
semi-Fowler’s or Fowler’s position
 16. Bronchoscopy postprocedure: semi-Fowler’s
position
17. Postural drainage: Trendelenburg’s position
18. Thoracentesis : sitting on the edge of the bed and
leaning over the bedside table with the feet
supported on a stool, or lying in bed on the
unaffected side with the client in Fowler’s position.
19. Abdominal aneurysm resection After surgery, limit
elevation of the head of the bed to 45 degrees
20. Amputation of the lower extremity
During the first 24 hours after amputation,: elevate
the foot of the bed (the residual limb is
supported with pillows)
21. Cardiac catheterization:The affected extremity is
kept straight and the head is elevated no more than
30 degree
22.Heart failure and pulmonary edema: upright
23. Peripheral arterial disease : elevate theirfeet at rest,
but they should not raise their legsabove the level of the
heart
24.Deep vein thrombosis :Bed rest with leg elevation
25.Varicose veins: Leg elevation above heart level
26.Cataract surgery: Postoperatively, semi-Fowler’s to
Fowler’s position
27.Autonomic dysreflexia: : high Fowler’s position
28.Cerebral aneurysm : head of the bed elevated 30 to 45
degrees
29. Cerebral angiograph : The extremity into which the
contrast medium was injected is kept straight and
immobilized for about 6 to 8 hours
30. Stroke (brain attack)
a. hemorrhagic strokes, the head of the bed is elevated
to 30 degrees
b. ischemic strokes, the head of the bed is usually kept
flat.
31.Craniotomy (unaffected site.) Elevate the head of the
bed 30 to 45 degrees
32.Laminectomy and other vertebral surgery: Logroll the
client.
33.Increased intracranial pressure
a. Elevate the head of the bed 30 to 45 degreesand
maintain the head in a midline, neutralposition
b. Avoid extreme hip and neck flexion.
34.. Lumbar puncture
a. During the procedure, lateral side-lying position
b. After the procedure : supine position
35. Spinal cord injury : Logroll
36.Bronchoscopy After: Semi-Fowler’s
37.Cerebral angiography
a.During: Flat on bed with arms at sides; kept still.
b.After: Extremity in which contrast was injected is kept
straight for 6 to 8 hours. Flat, if femoral artery was used. Apply
firm pressure on site for 15 minutes after the procedure
38.Myelogram (air contrast)
a. Pre-op: surgical table will be moved to various positions
during test.
b. Post-op: HOB is lower than trunk.
39. Myelogram (oil-based dye)
a. Pre-op: surgical table will be moved to various positions
during test.
b. Post-op: Flat on bed for 6 to 8 hours
40. Myelogram (water-based dye)
a. Pre-op: surgical table will be moved to various positions
during test.
b. Post-op: HOB elevated for 8 hours.
41. Liver biopsy
a. During: Supine with RIGHT side of upper abdomen exposed;
RIGHT arm raised and extended behind and and overhead and
shoulder.
b. After: RIGHT side-lying with pillow under puncture site.
42..Lung biopsy Flat supine with arms raised above head and
hands health together; head and arms on pillow..
43. Renal biopsy PRONE with pillow under the abdomen and
shoulders.
44.Arteriovenous fistula Post-op: Elevate extremity.
45.Peritoneal Dialysis When outflow is inadequate: turn patient
from side to side.
46.Meniere's Disease Change position slowly; bedrest during
acute
47.Autografting Immobilize site for 3 to 7 days.
48.Internal radiation, during treatment Strict bedrest while
implant is in place
49.Heart failure with pulmonary edema Sitting up, with legs
dangling.
50.Myocardial infarction Semi-Fowler’s
51.Pericarditis High-Fowlers, upright leaning forward.
52.Peripheral artery disease Depending on desired outcome.
Slight elevation of legs but not above the heart or slightly
dependent. Dangle legs on side of the bed
53.Shock Flat on bed. To improve or increase circulation.
54.Sickle Cell Anemia HOB elevated 30 degrees, avoid knee
gatch and putting strain on painful
55.Varicose veins, leg ulcers, and venous insufficiency Elevate
extremities above heart level.
56. Deep vein thrombosis Bed rest with affected limb elevated.
After 24 hours after heparin therapy, patient can ambulate if
pain level permits.
57.Tracheoesophageal fistula (TEF) HOB elevated 30-45
degrees.
58.Ventriculoperitoneal shunt (for Hydrocephalus treatment)
After shunt placement: Place on non-operative side in flat
position. HOB raised 15-30 degrees if ICP is increased. Do
not hold infant with head elevated.
59. Hyphema Blood in anterior chamber of eye HOB elevated
30-45 degrees, with night shield.
60. Abdominal aneurysm Post-op: HOB no more than 45
degrees.
61. Dehiscence Place in low-Fowler’s position then raise knees
or instruct knees and support them with a pillow..
62. Dumping Syndrome, prevention of Take meals in reclining
position, lie down for 20-30 minutes after.
63. Evisceration Place in low-Fowler’s position..
64.Gastroesophageal reflux disease (GERD)
Adult:Reverse Trendelenburg, slanted bed with head higher.
Pediatric: prone with HOB elevated.
65.Hiatal hernia Upright position after meals.
66.Pyloric stenosis RIGHT side-lying position after meals.
67.Extremity burns Elevate extremity..
68.Facial burns or trauma Head elevated
69.Autonomic dysreflexia Initially place in sitting position or
high Fowler’s position with legs dangling..
70.Cerebral aneurysm HOB elevated 30-45 degrees; bed rest
71.Heat stroke Supine, flat with legs elevated.
72.Hemorrhagic stroke HOB elevated 30 degrees.
73.Increased intracranial pressure (ICP) Elevate HOB 30-45
degrees, maintain head midline and in neutral position.
74.Ischemic stroke HOB flat in midline, neutral position.
75.Seizure Side-lying or recovery position.
76.Spinal cord injury Immobilize on spinal backboard, head in
neutral position and immobilized with a firm, padded cervical
collar Must be log rolled without allowing any twisting or
bending movements.
77.Head injury Elevate HOB 30 degrees, head should be kept in
neutral position.
78.Buck’s Traction Elevate FOB for counter-traction; use
trapeze for moving; place pillow beneath lower legs.
79.Casted arm Elevate at or above level of heart
80.Delayed prosthesis fitting Elevate foot of bed to elevate
residual limb.
81.Hip fracture Affected extremity needs to be abducted
82.Hip replacement On unaffected side: maintain abduction
when in supine position with pillow between legs. HOB raised
to 30-45 degrees.
83.Immediate prosthesis fitting Elevate residual limb for 24
hours.
84.Osteomyelitis Support affected extremity with pillows or
splints
85.Total hip replacement Help to sitting position; place chair at
90 degrees angle to bed; stand on affected side; pivot patient
to unaffected side.
86..Acute Respiratory Distress Syndrome (ARDS) High
Fowler’s
87.Air embolism from dislodged central venous line :Turn to
LEFT side or place in Trendelenburg. Patient should be
immediately repositioned with the right atrium above the gas
entry site so that trapped air will not move into the pulmonary
circulation.
88.Asthma High Fowler’s Tripod position: sitting position while
leaning forward with hands on knees.
89.Chronic Obstructive Pulmonary Disease (COPD) High
Fowler’s Orthopneic position
90.Emphysema :High Fowler’s Orthopneic position
91. Pleural Effusion :High Fowler’s
92.Pneumonia : High Fowler’s ,Lay on affected side ,Lay with
affected lung up
93.Pneumothorax :High Fowler’s
94.Pulmonary edema High Fowler’s, legs dependent position
95.Pulmonary embolism High Fowler’s Turn patient to LEFT
side and lower HOB
96.Flail chest High Fowler’s
97. Rib fracture High Fowler’s
98. Contraction stress test (CST) Placed in semi-Fowler’s or
side-lying position
99. Cord prolapse Shrimp or fetal position; modified Sims’ or
Trendelenburg.
100. Fetal distress Turn mother to her LEFT side.
101. Late decelerations (placental insufficiency) Turn mother to
her LEFT side.
102. Placenta previa Sitting position..
103. Variable decelerations (cord compression) Place mother
in Trendelenburg position.
104. Spina Bifida Prone (on abdomen).
105. Cleft lip (congenital) Position on back or in infant seat.
Hold in upright position while feeding.
106.Prolapsed umbilical cord During labor: Knee-chest
position or Trendelenburg.
107.Cardiac catheterization (post) HOB elevated no more than
30 degrees or flat as prescribed. May turn to either side
108.Continuous Bladder Irrigation (CBI) Tape catheter to thigh;
no other positioning restrictions
109.Ear drops Position affected ear uppermost then lie on
unaffected ear for absorption. Pull outer ear upward and back
for adults; upward and down for children.
110.Ear irrigation
a.During procedure: Tilt head towards affected ear.
b.After procedure: Lie on affected side for drainage.
111.Eye drops Tilt head back and look up, pull lid down.
112.Lumbar puncture
a.During: Shrimp or fetal position (side-lying with back bowed,
knees drawn up to abdomen, neck flexed to rest chin on
chest).
b.After: Flat on bed for 4-12 hours.
113.Nasogastric tube insertion High Fowler’s with head tilted
forward
114.Nasogastric tube irrigation and tube feedings
a.HOB elevated 30 to 45 degrees; keep elevated for 1 hour
after an intermittent feeding.
b.With decreased LOC: RIGHT side-lying with HOB elevated.
c.With tracheostomy: Maintain in semi-Fowler’s position
115.Paracentesis
 a.During: Semi-Fowler’s in bed or sitting upright on side of
bed with chair; support the feet.
b.Post: Assist into any comfortable position
116.Postural Drainage Trendelenburg
117.Rectal enema administration Left side-lying (Sims’
position) with right knee flexed.
118.Rectal enemas and irrigation Left side-lying, Sims’ position
119.Sengstaken-Blakemore and Minnesota tubes HOB elevated
120. Thoracentesis
a. Before: (1) Sitting on edge of bed while leaning on
bedside table with feet supported by stool; or lying in bed on
unaffected side with head elevated 45 degrees.
(2) Lying in bed on unaffected side with HOB
elevated to Fowler’s.
b.After: Assist patient into any comfortable position
preferred.
121.Total Parenteral Nutrition (TPN) During insertion:
Trendelenburg.
122.Vascular extremity graft Bed rest for 24 hours, keep
extremity straight and avoid knee or hip flexion
123.Perineal procedures Lithotomy
124.Appendectomy Post-op: Fowler’s position
125.Cataract surgery Sleep on unaffected side with a night
shield for 1 to 4 weeks. Semi-Fowler’s or Fowler’s on back or
on non-operative side.
126.Craniotomy HOB elevated 30-45% with head in a midline,
neutral position. Never put client on operative side, especially
if bone was removed.
126.Hemorrhoidectomy During: Prone Jackknifeposition.
127.Hypophysectomy Surgical removal of the pituitary gland.
HOB elevated.
128.Infratentorial surgery Incision at back of head, above nape
of neck Flat and lateral on either side; avoid neck flexing.
129.Kidney transplant Post-op: Semi-Fowler’s, turn from back
to nonoperative side
130.Laminectomy a.Back is kept straight.
b.Patient is logrolled if turned.
c.Sit straight in straight-backed chair when out
of bed or when ambulating.
131.Laryngectomy HOB elevated 30-45 degrees
132.Mastectomy Semi-Fowler’s with arm on affected side
elevated.
133.Mitral valve replacement
134.Post-op: semi-Fowler’s position.
135.Myringotomy Post-op: Position on side of affected ear .
136. Retinal detachment Bed rest with minimal activity and
repositioning. Area of detachment should be in the dependent
position.
137.Supratentorial surgery Incision front of head below hairline
HOB elevated 30-45 degrees; maintain head/neckline in
midline neutral position; avoid extreme hip and neck flexion.
138.Thyroidectomy Post-op: High Fowler’s or semi-Fowler’s.
Avoid extension and movement by using sandbags or pillows.
139. Tonsillectomy Post-op: prone or side-lying
140. Bone marrow aspiration/biopsy Side lying with head
tucked and legs pulled up or; Prone with arms folded under
chin.
141. Amputation: above the knee Elevate for first 24 hours
using pillow.
position prone twice daily.
142. Amputation: below the knee Foot of bed elevated for first
24 hours. Position prone daily.