A practical nurse is reinforcing teaching with a client who has a right short-leg cast about how to ascend stairs using axillary crutches. In which order should the nurse instruct the client to perform the following actions? Arrange the steps from first to last.
- 1Assume the tripod position at the base of the stairs.
- 2Transfer body weight entirely onto the crutch handles.
- 3Step up onto the first stair with the unaffected left leg.
- 4Shift body weight from the crutches to the unaffected left leg.
- 5Bring the crutches and the affected right leg up to the stair.
Answer
The correct sequence is: Assume the tripod position, transfer weight to the crutches, step up with the unaffected leg, shift weight to the unaffected leg, and finally bring the crutches and affected leg up.
When ascending stairs with crutches, the client must follow the safety principle of 'up with the good'. The client begins in a stable tripod position and transfers weight to the crutch handles. The unaffected (strong) leg is then placed on the step above. Once the strong leg is firmly planted, the client shifts their weight onto it. Finally, the client uses the strong leg to elevate the body, bringing the crutches and the affected (weak) leg up to the same step. This sequence ensures that the strong leg does the work of lifting the body against gravity.
Step-by-Step Solution
Key Concept
Assistive Device Ambulation: Ascending Stairs