Nursing & Healthcare Programs

Orthopneic Position

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Patients with respiratory illnesses such as chronic obstructive pulmonary disease (COPD) find ways to help themselves breathe more easily. This can include sleeping with extra pillows to keep them propped up or leaning forward to ease the work of breathing. The orthopneic position is one forward-leaning position used to help patients breathe comfortably when they are having difficulty.

Achieving Orthopneic Position

  1. Start with the patient in Fowler’s position with the body in proper alignment.
  2. Place the bedside table over the patient’s lap.
  3. Lay one to two pillows on the table. Place the patient’s arms on the pillows and have the patient lean forward onto their arms.
  4. This position can also be achieved if the patient is sitting in a chair by following steps two and three.
  5. Ask the patient if they are comfortable. Make adjustments as necessary.
  6. Document the position per institutional or unit policy. Report any difficulty getting the patient into position or maintaining position to the nurse per policy.

References

Activity and mobility. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 210-213). St. Louis, MO: Mosby Elsevier.

S. A. Sorrentino, & L. N. Remmert. (2012). Oxygen needs. In Mosby’s textbook for nursing assistants (8th ed., pp 620). St. Louis, MO: Elsevier Mosby.

More Resources

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

Prone Position

Prone position is not used as commonly as other patient positions. This position allows for full extension of the hips and the knees and gives many bony prominences a break from continuous pressure. However, placing patients in prone position does not come without the risks of pressure ulcers.

Measuring the Respirations

Respiration is a vital sign that is measured frequently in the healthcare setting. Taking this measurement requires no equipment and relatively little time. However, it is a measurement that must be taken accurately, as a change in respiration may indicate the worsening of a patient’s condition.

Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling.