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Question

Difficulty: MediumBasic Care and Comfort

A practical nurse is preparing to transfer a client who has right-sided weakness from the bed to a wheelchair. In which order should the nurse perform the following actions? (Arrange the items in the correct sequence from first to last.)

  1. 1Place the wheelchair on the client's left side at a 45-degree angle to the bed.
  2. 2Lock the brakes on both the bed and the wheelchair.
  3. 3Lower the bed and assist the client to sit on the edge with feet flat on the floor.
  4. 4Securely fasten a transfer (gait) belt around the client's waist.
  5. 5Assist the client to stand and pivot on the strong leg toward the wheelchair.

Answer

The correct sequence ensures maximum safety by first establishing the environment (positioning and locking the wheelchair on the strong side), stabilizing the client (sitting and dangling), applying safety equipment (gait belt), and finally executing the transfer.
Safe client mobility requires a rigid sequential approach: environmental preparation (chair placement and locking) must occur before client preparation (positioning and safety devices), which must occur before the physical movement (standing and pivoting).

Step-by-Step Solution

1
Place the wheelchair on the client's left side at a 45-degree angle to the bed.
The wheelchair is properly positioned on the client's unaffected side.
Because the client has right-sided weakness, placing the chair on the left allows them to use their stronger arm and leg to support their weight and guide the transfer.
2
Lock the brakes on both the bed and the wheelchair.
The environment is completely immobilized.
Locking the brakes prevents sudden, unexpected movement of the bed or chair, which is a primary cause of transfer-related injuries.
3
Lower the bed and assist the client to sit on the edge with feet flat on the floor.
The client is in a dangling position with a solid base of support.
Dangling allows the cardiovascular system to adjust to the upright position, minimizing dizziness, while flat feet provide necessary stability.
4
Securely fasten a transfer (gait) belt around the client's waist.
Safety equipment is in place.
Applying the gait belt while the client is safely seated ensures a snug fit, providing the nurse with a secure hold to safely guide the client's movements.
5
Assist the client to stand and pivot on the strong leg toward the wheelchair.
The client safely completes the transfer to the wheelchair.
Pivoting on the unaffected left leg ensures the client can support their own weight securely during the transition into the chair.

Key Concept

Safe Client Transfer and Mobility Principles
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Topics

Basic Care and Comfort

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