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Difficulty: HardErgonomics and Safe Use of Equipment

An assigned client is recovering from a left hemisphere cerebrovascular accident that caused right-sided hemiplegia. The nurse is planning to move the client from the bed to a wheelchair. To maintain optimal body mechanics and ensure safety, arrange the following steps in the sequence they should be performed.

  1. 1Place the wheelchair at a 45-degree angle on the client's left side and lock the wheels.
  2. 2Assist the client to sit on the side of the bed and apply non-skid footwear.
  3. 3Secure a transfer belt firmly around the client's waist.
  4. 4Stand facing the client with a wide stance and brace the client's right knee with your own knee.
  5. 5Ask the client to place their left hand on the mattress and push up to a standing position.
  6. 6Pivot toward the left side until the back of the client's legs touch the wheelchair seat, then lower them.

Answer

The correct sequence is to first position the wheelchair on the client's strong (left) side and lock it, sit the client up and apply safe footwear, apply the transfer belt, brace the weak (right) knee, have the client push up with their strong arm, and finally pivot toward the strong side to sit.
Safe transfer of a client with hemiplegia requires strict adherence to ergonomic principles. The environment must be prepared first by placing the wheelchair on the unaffected side and locking it. The client is then brought to a seated position with non-skid footwear and a gait belt applied for a secure hold. To protect both parties, the nurse must brace the paralyzed leg to prevent buckling, while encouraging the client to use their strong arm and leg to assist in the lift. Finally, pivoting toward the strong side ensures the client can support the movement before safely sitting.

Step-by-Step Solution

1
Place the wheelchair at a 45-degree angle on the client's left side and lock the wheels.
The equipment is safely secured on the client's strong side.
Prevents the chair from moving and allows the client to pivot toward their unaffected side, utilizing their own strength.
2
Assist the client to sit on the side of the bed and apply non-skid footwear.
The client is seated with stable footing.
Ensures the client is acclimated to an upright position and has traction to prevent slipping.
3
Secure a transfer belt firmly around the client's waist.
The nurse has a secure ergonomic hold point.
Grasping the belt rather than the client's arms or clothing prevents musculoskeletal injury to both the client and the nurse.
4
Stand facing the client with a wide stance and brace the client's right knee with your own knee.
The nurse is ergonomically positioned and the client's weak leg is supported.
Bracing the hemiplegic leg prevents it from collapsing when weight is applied.
5
Ask the client to place their left hand on the mattress and push up to a standing position.
The client assists in bearing their own weight.
Using the client's functional strength minimizes the lifting burden on the nurse.
6
Pivot toward the left side until the back of the client's legs touch the wheelchair seat, then lower them.
The client is safely seated in the wheelchair.
Tactile feedback on the back of the legs confirms proper positioning before lowering, preventing a fall.

Key Concept

Safe Patient Transfer and Ergonomics for Hemiplegia
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Topics

Ergonomics and Safe Use of Equipment

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