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Difficulty: MediumBasic Care and Comfort

A nurse is preparing to transfer a client with right-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.

  1. 1Position the wheelchair on the client's left side at a 45-degree angle to the bed and lock the wheels.
  2. 2Assist the client to a sitting position on the edge of the bed and ensure their feet rest flat on the floor.
  3. 3Apply a transfer (gait) belt securely around the client's waist.
  4. 4Stand facing the client, grasp the transfer belt on both sides, and brace the client's right leg with your knee.
  5. 5Instruct the client to push off the bed with their left arm, stand, and pivot on their left leg to sit in the wheelchair.

Answer

The correct sequence is: Position the wheelchair on the strong side and lock wheels, assist the client to sit on the edge of the bed, apply a transfer belt, face the client and brace the weak knee, and finally instruct the client to push off and pivot using their strong side.
Safe transfer of a client with unilateral weakness requires a systematic approach that maximizes the use of the client's strong side while providing structural support to the weak side. The sequence begins with environmental preparation (placing the chair on the strong left side and locking wheels), followed by positioning the client safely on the bed edge. A gait belt is then applied for safety, and the nurse assumes a stance that supports the weak right leg. Finally, the physical pivot is executed using the strong side.

Step-by-Step Solution

1
Determine the optimal placement for the wheelchair.
The wheelchair is placed on the client's left (unaffected) side at a 45-degree angle with wheels locked.
Always transfer toward the strong side so the client can bear weight and pivot safely without collapsing.
2
Mobilize the client to a ready position.
The client sits on the edge of the bed with feet flat on the floor.
Sitting on the edge allows the client to stabilize physically and prevents orthostatic hypotension before standing.
3
Secure safety equipment.
A transfer belt is applied securely around the client's waist.
The belt provides a firm handhold for the nurse, significantly reducing the risk of dropping or injuring the client.
4
Establish a supportive stance.
The nurse faces the client, holds the belt, and braces the client's weak right knee with their own knee.
Bracing the affected knee prevents it from buckling when the client attempts to bear weight during the transfer.
5
Execute the transfer.
The client pushes off the bed, stands, pivots on the left leg, and gently sits in the wheelchair.
Using the strong arm and leg maximizes the client's independence and safety during the pivoting motion.

Key Concept

Safe client transfer techniques prioritizing weight-bearing on the unaffected side and proper use of safety equipment.
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Topics

Basic Care and Comfort

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