Which combination accurately pairs a bony prominence with a protective strategy for side-lying positioning?

• A. Sacrum—pillow under the torso; greater trochanter—pillow between the knees; lateral malleolus—proper padding and heel off-loading.
• B. Ischial tuberosity—padding behind the thigh; greater trochanter—pillow between the knees; lateral malleolus—heel off-loading.
• C. Sacrum—pillow under the torso; greater trochanter—pillow between the knees and at the hip; lateral malleolus—proper padding and heel off-loading.
• D. Scapula—foam wedge; lateral malleolus—pad the elbow; Iliac crest—heel padding.

Answer: (C)

In side-lying, the goal is to reduce pressure and shear on vulnerable bony areas by using targeted padding and proper limb alignment. Placing a pillow under the torso relieves sacral pressure, since the sacrum is a primary contact point when the body lies on its side. Protecting the greater trochanter requires cushioning both at the hip itself and between the knees to keep the pelvis aligned and to distribute load away from the outer hip. A pillow between the knees helps maintain hip neutral alignment and reduces pressure on the greater trochanter by preventing the top hip from grinding against the bed. Adding padding at the hip provides direct cushioning to the greater trochanter, offering additional protection where contact and pressure are most likely.

For the lower leg, padding the lateral malleolus helps prevent pressure on the outer ankle, and heel off-loading reduces risk of heel pressure injuries, which are common when the leg rests against the bed for extended periods.

This combination is more comprehensive than others because it addresses the sacrum, the greater trochanter, and the distal leg—each a key pressure point in side-lying—while ensuring the pelvis stays aligned and the heels are protected.