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Question

Difficulty: MediumBasic Care and Comfort

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

  1. 1Position the wheelchair on the client's right side at a 45-degree angle to the bed.
  2. 2Lock the brakes on both the bed and the wheelchair.
  3. 3Assist the client to a sitting position on the edge of the bed and ensure their feet are flat on the floor.
  4. 4Apply a transfer belt securely around the client's waist.
  5. 5Brace the client's left leg, assist them to a standing position, and pivot into the wheelchair.

Answer

The correct sequence is: position the wheelchair on the strong side, lock the brakes, assist the client to a sitting position, apply the transfer belt, and finally assist the client to stand and pivot.
The correct sequence prioritizes environmental preparation, equipment safety, client physiological readiness, the application of safety devices, and finally, the execution of the transfer using proper body mechanics.

Step-by-Step Solution

1
Position the wheelchair on the client's strong side (right side) at a 45-degree angle.
The wheelchair is optimally aligned for the safest possible transfer.
Transferring toward the strong side allows the client to bear weight and use their unaffected limbs for support during the pivot.
2
Lock the brakes on the bed and wheelchair.
Both surfaces are completely immobilized.
This prevents the equipment from sliding away during the weight shift, significantly reducing the risk of a fall.
3
Assist the client to sit on the edge of the bed with their feet flat on the floor.
The client is upright and stabilized with a solid base of support.
Dangling allows the body to adjust to the position change, preventing dizziness from orthostatic hypotension before standing.
4
Apply a transfer belt snugly around the client's waist.
The nurse has a secure, mechanical grip point.
A gait belt decreases the risk of dropping the client and prevents injury to the nurse's back or the client's limbs by avoiding lifting under the arms.
5
Brace the weak leg, assist the client to stand, and pivot.
The client is safely moved from the bed into the wheelchair.
Bracing the hemiparetic left leg prevents the knee from collapsing under the client's body weight, ensuring a controlled descent into the chair.

Key Concept

Safe Client Transfer and Mobility Principles
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Topics

Basic Care and Comfort

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