Turning
The repositioning of an immobile or at-risk patient at scheduled intervals to relieve pressure over bony prominences and prevent pressure injuries.
On the exam, turning items hinge on technique, not just frequency: the tested rule is the 30 degree lateral (tilted side-lying) position rather than a full 90 degree side-lying, because lying directly on the greater trochanter concentrates pressure and causes injury. Float the heels off the bed entirely, often with a pillow under the full length of each calf (heel suspension), and never use donut/ring cushions or massage reddened bony prominences — both are wrong answers that worsen ischemia. The classic “tell” is non-blanchable erythema over the sacrum: this is a Stage 1 pressure injury on intact skin, so the priority is to offload immediately and reposition more often, not to treat it like an open wound.
Distinguish turning from its neighbors: positioning is goal-driven placement (Fowler’s for breathing, HOB 30–45 degrees against aspiration), while mobility/ambulation prevents DVT and pneumonia. The trap is choosing turning when a patient who can move should be ambulated instead. Memory hook: “30 degrees, heels in the air.”
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