| Assisting a Client to the Sitting Position | 協(xié)助病人起坐 |
| A partially immobilized or weak client will require nursing assistance to sit up in bed. The nurse can help such a client attain the sitting position while maintaining proper body alignment for herself and the client, Correct positioning techniques will reduce the risk of musculoskeletal injury to all persons involved. | 局部固定或體弱病人在床上坐起時需要護(hù)理協(xié)助。護(hù)士能夠幫助此病人達(dá)成坐位，并保持身體正位。手勢正確可以減少相關(guān)人員肌肉骨骼損傷的危險?！?/td> |
Potential Nursing DiagnosesImpaired physical mobility
Activity intolerance
Impaired skin integrity | 潛在護(hù)理診斷軀體活動受損
活動不耐受
皮膚完整性受損 |
1. Wash hands and, if appropriate, don gloves.
* Reduces transmission of microorganisms. | 1. 洗手，帶手套。
＊減少細(xì)菌傳播 |
2. Place client in supine position.
* Enables you to continually assess client's body alignment and administer additional care, such as suctioning or hygiene needs. | 2. 使病人仰臥
＊ 便于護(hù)士持續(xù)評估病人體位，實施抽吸、衛(wèi)生等其他護(hù)理 |
3. Remove all pillows.
* Decreases interference while sitting client up in bed. | 3. 去枕
＊ 減少病人床上坐起障礙?！?/td> |
4. Face head of bed.
* Reduces twisting of your body when moving client. | 4. 面向床頭。
＊ 減少移動病人時身體扭傷危險?！?/td> |
5. Place your feet apart with foot nearer bed behind other foot.
* Improves your balance and allows you to transfer your body weight as client is moved to sitting position. | 5. 雙腳開立，一腳在前靠床，另腳在后
＊ 改善護(hù)士身體平衡，便于護(hù)士在病人移至坐位時轉(zhuǎn)移自身體重。 |
6. Place hand that is farther from client under client's shoulders, supporting his head and cervical vertebrae.
* Maintains alignment of client's head and cervical vertebrae and allows for even lifting of his upper trunk. | 6. 一手（離病人稍遠(yuǎn)的手）置于病人肩下，支撐病人頭、頸
＊ 保持病人頭、頸正直，便于平穩(wěn)抬起病人上身 |
7. Place your other hand on bed surface.
* Provides support and balance. | 7. 另一只手放于床面
＊ 提供支撐和平衡 |
8. Raise client to a sitting position by shifting your weight from front leg to back leg.
* Improves your balance, overcomes inertia, and transfers your weight in direction of move. | 8. 重心由前腿移至后腿，扶起病人至坐位
＊ 改善身體平衡，克服慣性，使體重重心與移動方向一致 |
9. Push against bed with the hand that is on bed surface.
* Divides activity of raising client to a sitting position between your arms and legs and protects your back from strain.
* By bracing one hand against mattress and pushing against it as you lift client, you transfer part of weight that would be lifted by your back muscles to your arm and onto mattress. | 9. 手撐床鋪
＊ 將手、腿分擔(dān)扶起動作，防止背部扭傷
＊ 抬起病人時，一手撐床、下按，將背部肌肉承擔(dān)的部分重力轉(zhuǎn)移到手臂和床墊 |
10. Remove gloves and wash hands.
* Reduces transmission of microorganisms | 10. 脫去手套，洗手。
＊ 減少微生物傳播?！?/td> |
11. Record client's new position in nurse's notes.
* Documents that procedure was performed. | 11. 將病人新體位記錄在護(hù)理記錄上。
＊ 記錄操作已經(jīng)完成 |
| Nurse AlertThe nurse must avoid dragging a client up in bed. Dragging against the bed linen causes shearing force. In addition, she should carefully observe the client for signs of development of postural hypotension （e.g., dizziness, fainting）. | 注意事項：必須避免在床上拖拉病人，床上拖拉會產(chǎn)生剪力。此外，護(hù)士還應(yīng)仔細(xì)觀察病人有無出現(xiàn)體位性低血壓體癥（如頭暈、昏厥）?！?/td> |
| Client TeachingThis skill provides an opportunity for the client and family to learn appropriate body alignment for the sitting position. | 病人宣教：本技能使護(hù)士有機(jī)會教育病人和家人了解坐姿時的正確身體定位。 |
| Pediatric ConsiderationsChildren are usually easy to move, and the nurse may be able to simply raise a child to the sitting position. | 兒科：兒童容易移動，護(hù)士可輕易地扶起兒童至坐位?！?/td> |
| Geriatric ConsiderationsElderly clients with degenerative joint disease （osteoarthritis） are at greater risk than are younger clients of shoulder joint dislocation while being moved. In addition, their decreased muscle mass and reduced skin elasticity; and skin moisture increase the risk of skin breakdown from shearing force. | 老年病人：有退行性關(guān)節(jié)疾病（骨關(guān)節(jié)炎）的老年病人，在移動時出現(xiàn)肩關(guān)節(jié)脫臼的危險要大于年輕病患。而且，老年病人肌肉萎縮、皮膚彈性降低及皮膚水份減少也會增加剪力引起的皮膚開裂的危險?！?/td> |
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