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Difficulty: Very hardErgonomics and Safe Use of Equipment

An older adult client who underwent a right total hip arthroplasty 48 hours ago requires movement from their bed to a specialized cardiac chair. The client is currently disoriented and receiving continuous intravenous (IV) fluids. A practical nurse (PN) and an assistive personnel (AP) are collaborating to execute this task using a full-body mechanical lift. Which actions indicate that the PN is correctly managing the equipment, body mechanics, and environmental safety? (Select all that apply.)

  1. Adjust the bed height to the level of the PN's waist before rolling the client to position the canvas slingAnswer
  2. Maintain the mechanical lift's base wheels in the unlocked position during the active lifting phase to allow the device to center itselfAnswer
  3. C
    Secure the sling straps to the back of the cardiac chair after the transfer to prevent the disoriented client from attempting to stand
  4. D
    Administer a prescribed intravenous push (IVP) anxiolytic medication to calm the client's disorientation prior to operating the lift motor
  5. Expand the legs of the mechanical lift base to their widest setting prior to hoisting the client's weightAnswer
  6. F
    Configure the sling loops so the client's hips flex to a 110-degree angle, ensuring a deep center of gravity that prevents slipping

Answer

The correct actions involve adjusting the bed to waist height for sling placement, maintaining the lift's base wheels unlocked during the hoist, and expanding the lift legs to their widest setting.
Safe use of a mechanical lift requires maximizing the base of support (expanding the legs) and allowing the machine to distribute weight naturally (leaving wheels unlocked during the lift). Furthermore, raising the bed to waist level prior to moving the patient protects the nurse from ergonomic injuries.

Step-by-Step Solution

1
Evaluate the client's surgical history and current cognitive state.
Identifies the requirement for strict hip precautions and the risks associated with the client's disorientation.
Total hip arthroplasty severely limits safe hip flexion (must remain <90 degrees), and disorientation increases the likelihood of unpredictable patient movements.
2
Apply ergonomic principles during the preparatory phase of the transfer.
The bed is elevated to waist level for rolling the client to place the sling.
Raising the work surface prevents spinal stress and reduces the risk of occupational musculoskeletal injury for the healthcare team.
3
Configure and operate the mechanical lift to ensure maximum stability.
The lift's base legs are fully widened, and the casters are left unlocked while lifting.
A widened base increases the supportive footprint. Unlocked wheels allow the lift mast to auto-center over the shifting weight of the patient, neutralizing tipping forces.
4
Ensure all nursing interventions remain strictly within the legal scope of practice and safety protocols.
The nurse refrains from administering IV push medications and rejects using the sling as a tie-down restraint.
IV push administration exceeds the PN scope of practice, and improvising physical restraints violates patient rights and safety laws.

Key Concept

Integration of mechanical lift safety physics, proper ergonomic positioning, postoperative hip precautions, and legal scope of practice.
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Topics

Ergonomics and Safe Use of Equipment

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