Chapter 3. Safe Patient Handling, Positioning, and Transfers Show
Immobility in hospitalized patients is known to cause functional decline and complications affecting the respiratory, cardiovascular, gastrointestinal, integumentary, musculoskeletal, and renal systems (Kalisch, Lee, & Dabney, 2013). For surgical patients, early ambulation is the most significant factor in preventing complications (Sanguinetti, Wild, & Fain, 2014). Lack of mobility and ambulation can be especially devastating to the older adult when the aging process causes a more rapid decline in function (Graf, 2006). Ambulation provides not only improved physical function, but also improved emotional and social well-being (Kalisch et al., 2013). Prior to assisting a patient to ambulate, it is important to perform a patient risk assessment to determine how much assistance will be required. An assessment can evaluate a patient’s muscle strength, activity tolerance, and ability to move, as well as the need to use assistive devices or find additional help. The amount of assistance will depend on the patient’s condition, length of stay and procedure, and any previous mobility restrictions. Assisting Patient to the Sitting PositionPatients who have been immobile for a long period of time may experience vertigo, a sensation of dizziness, and orthostatic hypotension, a form of low blood pressure that occurs when changing position from lying down to sitting, making the patient feel dizzy, faint, or lightheaded (Potter, Perry, Ross-Kerr, & Wood, 2010). For this reason, always begin the ambulation process by sitting the patient on the side of the bed for a few minutes with legs dangling. Checklist 27 outlines the steps to positioning the patient on the side of a bed prior to ambulation (Perry, et al., 2014). Checklist 27: Assisting a Patient to a Sitting Position
Video 3.2Ambulating a PatientAmbulation is defined as moving a patient from one place to another (Potter et al., 2010). Once a patient is assessed as safe to ambulate, determine if assistance from additional health care providers or assistive devices is required. Checklist 28 reviews the steps to ambulating a patient with and without a gait belt. Checklist 28: Ambulating a Patient
Video 3.3Video 3.4Watch the video How to Ambulate with a Cane by Kim Morris of Thompson Rivers University. Video 3.5Watch a video How to Ambulate With Crutches by Kim Morris, Thompson Rivers University.
When you ask a patient to move their arm away from the body this movement is called?Moving a limb toward the midline of the body is called adduction; abduction is moving a limb away from the midline of the body. You just studied 52 terms!
How should a nurse assess the range of motion?Palpate and assess range of motion (ROM) and muscle strength: Gently palpate bones, joints, muscles, and surrounding tissue for heat, swelling, stiffness, tenderness, or crepitation. Ask the patient to move major joints (knees, shoulders, hips, and ankles) through the expected ROM movements.
What does the nurse assess each joint for?As you observe, palpate each joint for warmth, swelling, or tenderness. If you observe decreased active range of motion, gently attempt passive range of motion by stabilizing the joint with one hand while using the other hand to gently move the joint to its limit of movement.
Which of the following is the movement of a limb away from the midline of the body quizlet?Extension. Moving a limb toward the midline of the body is called adduction; moving a limb away from the midline of the body is called abduction. Flexion is bending a limb at a joint; and extension is straightening a limb at a joint.
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