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Difficulty: HardErgonomics and Safe Use of Equipment

An 82-year-old client who was previously oriented suddenly exhibits severe agitation and uncooperative behavior. A transfer is required from the mattress to a specialized seating device in the room. When determining the safest approach for client handling and equipment utilization, which actions should the practical nurse (PN) implement? Select all that apply.

  1. Engage the wheel-locking mechanisms on both the bed and the receiving chair prior to initiating the transfer.Answer
  2. Select a full-body mechanical sling lift rather than a motorized sit-to-stand device for this client.Answer
  3. C
    Document the sudden behavioral change as a normal age-related process and perform a manual two-person lift.
  4. D
    Assign an unlicensed assistive personnel (UAP) to independently perform the transfer using the mechanical lift.
  5. E
    Apply a physical vest restraint to secure the client to the bed while stepping into the hallway to locate the lift.
  6. Keep the bed in the lowest possible position and place high-impact fall mats on the floor next to the bed.Answer

Answer

The correct actions are to engage the wheel-locking mechanisms, select a full-body mechanical sling lift, and keep the bed in the lowest possible position with fall mats in place.
Transferring an agitated and uncooperative client requires prioritizing environmental safety and minimizing manual lifting to protect both the client and staff from injury. Utilizing a full-body sling lift eliminates the need for the client to bear weight or follow commands (which a sit-to-stand lift requires). Locking wheels prevents equipment drift, and utilizing low bed positions with fall mats provides a safe environment for a client experiencing acute delirium.

Step-by-Step Solution

1
Assess the client's current cognitive and physical status.
The client is identified as suddenly agitated and uncooperative, increasing the risk of falls and ruling out active participation in the transfer.
Client cooperation and weight-bearing ability dictate the type of transfer equipment required.
2
Select the appropriate ergonomic transfer equipment.
A full-body mechanical sling lift is chosen over a sit-to-stand device.
Sit-to-stand lifts require the client to follow commands and bear weight safely, which this agitated client cannot do.
3
Implement environmental and equipment safety measures.
Wheel locks are engaged, the bed is kept low, and fall mats are deployed.
These actions mitigate the risk of severe injury if the agitated client attempts to self-transfer or becomes combative during equipment setup.

Key Concept

Safe use of mechanical transfer equipment and environmental safety modifications for cognitively impaired or agitated clients.
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Topics

Ergonomics and Safe Use of Equipment

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