An older adult client who recently experienced a cerebrovascular accident has residual left-sided hemiparesis. The practical nurse is helping the client put on a clean, front-buttoning shirt. In what order should the nurse complete the following actions? Arrange the steps in the correct sequence from first to last.
- 1Assist the client to a safe, upright seated position on the edge of the bed or in a chair.
- 2Gather the left sleeve of the shirt and slide it gently over the client's left arm.
- 3Pull the body of the shirt carefully across the client's back toward the right side.
- 4Instruct the client to insert their right arm into the right sleeve.
- 5Fasten the front buttons of the shirt and smooth out any fabric wrinkles.
Answer
The correct sequence is to first sit the client upright, dress the weak left arm, pull the shirt around the back, have the client insert their strong right arm, and finally button the shirt.
The correct sequence prioritizes client safety by first establishing a secure seated position. When dressing a client with unilateral weakness (hemiparesis), the cardinal clinical rule is to dress the affected or weaker side first. This minimizes the need to move or stretch the impaired limb, thereby reducing the risk of joint injury and pain. After the weak arm (left) is dressed, the shirt is brought around the back, allowing the client to use their unaffected arm (right) to independently slide into the remaining sleeve. Finally, securing the buttons and smoothing the fabric completes the process and prevents pressure from wrinkled clothing.
Step-by-Step Solution
Key Concept
Activities of Daily Living (ADLs): Dressing a Client with Hemiparesis