Positioning and Transfer Techniques Flashcards

What is the PRIMARY purpose of proper body mechanics for a CNA?

Answer: To protect the CNA from musculoskeletal injury while safely transferring residents

Proper body mechanics protect the CNA's back and musculoskeletal system from injury by using large muscle groups, keeping the load close to the body, and avoiding twisting.

When preparing to lift or transfer a resident, the CNA should first:

Answer: Read the care plan for transfer instructions and check the resident's level of assistance needed

Always check the care plan first for specific transfer instructions, weight-bearing status, and assistive device requirements to ensure a safe, individualized transfer.

The safest position for a CNA's back when lifting is:

Answer: Back straight, knees bent, feet shoulder-width apart, and load close to the body

Proper lifting uses leg muscles (not the back), with a neutral spine (straight back), bent knees for a stable base, feet shoulder-width apart, and the load kept close to the body to minimize torque on the spine.

What does a 'two-person assist' transfer mean?

Answer: Two CNAs assist one resident to transfer safely

A two-person assist requires two caregivers to work together to safely transfer a resident who is partially or fully dependent, distributing the physical load and increasing safety for both staff and resident.

A transfer (gait) belt should be placed:

Answer: Around the resident's waist over clothing

A transfer belt is placed around the waist (over clothing, not bare skin) at the navel level, with 1–2 fingers fitting under it snugly. It gives the CNA a secure grip to guide and support the resident.

When should a transfer belt NOT be used?

Answer: When the resident has an abdominal wound, ostomy, colostomy, or recent abdominal surgery

Transfer belts should not be placed over abdominal wounds, ostomies, feeding tubes, or recent surgical incisions, as pressure can cause pain and injury. Check the care plan for contraindications.

The supine position is BEST described as:

Answer: Lying flat on the back (face up)

Supine position is lying flat on the back (dorsal recumbent). While comfortable for many procedures, prolonged supine positioning increases risk of pressure injuries at the occiput, shoulder blades, elbows, sacrum, and heels.

The prone position is BEST described as:

Answer: Lying face down on the abdomen

Prone position is lying face-down (on the abdomen). It is not commonly used in long-term care but can relieve pressure from the sacrum and heels, and is used for certain respiratory conditions.

The lateral (side-lying) position requires what to prevent pressure injury?

Answer: A pillow between the knees and positioning at a 30-degree angle

In lateral position, a pillow between the knees prevents pressure between bony prominences. A 30-degree lateral tilt (rather than 90 degrees) reduces direct pressure on the trochanter.

The Fowler's position places the head of the bed at:

Answer: 45–60 degrees

Standard Fowler's position elevates the head of the bed to 45–60 degrees. High Fowler's is 60–90 degrees. Semi-Fowler's is 30–45 degrees. Fowler's positions are used for feeding, respiratory support, and comfort.

Fowler's position is beneficial for residents who:

Answer: Have respiratory distress or need to eat/drink safely

Fowler's position improves lung expansion for residents with respiratory difficulties and reduces aspiration risk during eating and drinking by using gravity to keep food/liquid in the esophagus.

The Sims' position is used for:

Answer: Enemas, rectal examinations, and unconscious patients to prevent aspiration

Sims' position (semiprone, lying on the left side with the upper knee flexed) is used for enemas, rectal procedures, and unconscious residents because it allows secretions to drain from the mouth.

When transferring a resident from the bed to a wheelchair, the wheelchair should be placed:

Answer: At a 45-degree angle to the bed, on the resident's stronger side

The wheelchair is placed at 45 degrees to the bed, aligned with the resident's stronger side so they can lead with the stronger leg, which provides stability and reduces fall risk during the pivot.

Before locking the wheelchair brakes for a transfer, the CNA should ensure:

Answer: The brakes are locked and footrests are raised or swung away

Before any transfer, brakes must be locked to prevent the wheelchair from moving, and footrests must be raised or swung aside to allow the resident to stand and pivot without obstruction.

When helping a resident to stand from a seated position, the CNA should:

Answer: Instruct the resident to scoot to the edge, lean forward, and push up with arms, while the CNA guides and supports

Safe standing technique involves having the resident move to the edge of the chair, lean forward ('nose over toes'), and push up with their arms while the CNA uses a gait belt to guide and support — not lift.

A mechanical lift (Hoyer lift) is indicated when:

Answer: The resident cannot bear weight or assist with the transfer, requiring full-body lifting

A mechanical lift is used for dependent residents who cannot bear weight or assist with transfers. It prevents staff back injuries and provides a safe, dignified method for full-body lifting.

Before using a mechanical lift, the CNA must:

Answer: Inspect the sling for tears and check the equipment for proper function

The sling must be inspected for tears, fraying, or damaged hardware before each use. Malfunctioning equipment is a serious safety hazard and must be taken out of service immediately.

How many staff members are required to safely operate a mechanical lift?

Answer: At least two trained staff members

Mechanical lifts require at least two trained staff: one to operate the lift controls and guide the resident, and one to maintain resident safety and stability during the lift.

When using a draw sheet for repositioning a resident in bed, the CNA should:

Answer: Work with another staff member, roll the draw sheet close to the resident's body, and slide — not drag

Two staff members roll the draw sheet tightly against the resident's body and lift/slide together, which distributes the load safely and reduces friction and shear on the resident's skin.

To help prevent foot drop in a bedbound resident, the CNA should:

Answer: Use foot supports, padded boots, or position feet in dorsiflexion (toes pointed up)

Foot drop is prevented by positioning the feet at 90 degrees (dorsiflexion) using foot supports or boots, preventing the weight of blankets from pushing the feet into plantar flexion.