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Assisting with Ambulation

Assisting with Ambulation. Teresa V. Hurley, MSN, RN. Dangling a Client. Prevent injury Seated position at side of bed with feet touching the floor Gaze looking forward What is orthostatic hypotension?. Ambulation. Stand erect Gaze forward Heel to toe

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Assisting with Ambulation

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  1. Assisting with Ambulation Teresa V. Hurley, MSN, RN

  2. Dangling a Client • Prevent injury • Seated position at side of bed with feet touching the floor • Gaze looking forward • What is orthostatic hypotension?

  3. Ambulation • Stand erect • Gaze forward • Heel to toe • Opposite arm swing to opposite leg

  4. Nursing Assistance • One Nurse Assist • Two Nurse Assist

  5. Special Consideration • Client has one-sided weakness or paralysis • Nurse stands on the weaker or affected side • With arm around waist to stabilize the client

  6. Preventing Injury: Falls • Client begins to fall or feels faint • What are you going to do?

  7. Nurse Guides to Floor • Move hip forward closest to client with a wide base of support and have client slide down your leg into a sitting or lying position

  8. Walking Assistive Devices • Canes • Walkers • Braces • Walking belts

  9. Canes • Single-ended curve ended ideal for use with stairs • Single-ended straight ended used when balance is intact and hand weakness exists • Multi-prong used when there is balance problems because it has a wide base of support

  10. Canes • Rubber tipped • Sizing: bottom 4 inches to side of foot • Sizing: top reaches hip joint • Held with stronger side with elbow bent at 30 degree angle • Weight evenly distributed • Advance weaker leg and cane simultaneously • Swing stronger leg • Avoid leaning forward

  11. Walkers • Client picks up walker and advances as steps ahead • Impaired side advances first ahead after picks up walker

  12. Braces • Support joints and muscles that can not support body weight

  13. Crutches • Reliance on strength of arms and shoulders • Limit or eliminate weight bearing • Forearm Support Crutches used for permanentlimitations • Axillary Crutches used for short or long term

  14. Axillary Crutches • Body weight carried on arms and hands and not axilla • 2 Point Gait and 4 Point Gait used for partial weight bearing • 3 Point Gait non-weight bearing • Swing to and Swing through for weight bearing • Upstairs lead with unaffected and going down stairs lead witheffected

  15. Crutches • Measure by lying flat in bed with shoes used for walking • Measure from anterior fold of axilla to the heel and add 1 inch = 2.5 cm • Standing position: crutch pad should be three finger breaths from anterior fold of axilla

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