A registered nurse is providing discharge instructions to a client with a right tibial fracture who must maintain strict non-weight-bearing status on the affected extremity. Arrange the following steps in the correct chronological sequence for safely ascending a flight of stairs using bilateral axillary crutches without the use of a handrail.
- 1Assume a stable tripod stance facing the bottom of the staircase.
- 2Transfer body weight entirely onto the handgrips of the crutches.
- 3Advance the unaffected left leg up onto the stair tread.
- 4Shift body weight from the crutches onto the unaffected left leg.
- 5Bring both crutches and the affected right leg up to the stair tread.
Answer
The correct sequence for ascending stairs with crutches is to establish a tripod stance, transfer weight to the crutches, advance the unaffected leg up, shift weight to the unaffected leg, and finally bring the crutches and the affected leg up.
When ascending stairs with crutches, the fundamental principle is 'up with the good'. The client must first establish a stable tripod stance. Next, weight is shifted entirely to the upper body via the crutches so the strong, unaffected leg can be safely lifted onto the step. Once the strong leg is firmly planted on the step, the client shifts their weight onto that leg, using its strength to power the lift of the body. Finally, the client brings the crutches and the affected leg up together. This sequence ensures the injured extremity bears no weight and maximizes stability throughout the transfer.
Step-by-Step Solution
Key Concept
Crutch Walking on Stairs (Ascending)