A client recovering from a right-hemisphere cerebrovascular accident has left-sided hemiplegia and requires assistance moving from the bed to a bedside wheelchair. The client is alert, able to follow commands, and can bear partial weight on their unaffected leg. Arrange the following procedural steps in the correct chronological order to ensure a safe transfer.
- 1Position the wheelchair at a 45-degree angle to the bed on the client's right side and lock the wheels.
- 2Assist the client into a sitting position on the edge of the bed and pause to evaluate for dizziness.
- 3Securely fasten a transfer belt around the client's waist over their clothing.
- 4Stand facing the client and block their left foot and knee with your own foot and knee.
- 5Instruct the client to push off the mattress with their right hand, stand, and pivot toward the chair.
Answer
The correct sequence is to first position the wheelchair on the client's right (unaffected) side, assist the client to sit and dangle at the bedside, apply the transfer belt, block the client's left (weak) leg, and finally instruct the client to use their right hand to push up and pivot.
A safe transfer for a client with hemiplegia relies on biomechanics and compensating for the deficit. The environment is prepared first by placing the chair on the strong side. The client is then brought to a seated position to stabilize blood pressure. Safety equipment (transfer belt) is applied while seated. The nurse must then brace the weak extremity to prevent buckling before initiating the actual movement, which relies on the client's strong side pushing off.
Step-by-Step Solution
Key Concept
Safe client transfer techniques for hemiplegia require leading with the unaffected side and mechanically supporting the paralyzed extremity.
Estimated Time:1m 30s