A nurse is teaching a client who has a prescribed non-weight-bearing status on the right leg how to ascend stairs using crutches. In what order should the nurse instruct the client to perform the following steps? Arrange the actions in the correct sequence.
- 1Assume the tripod stance at the base of the stairs.
- 2Place full body weight on the crutch hand grips.
- 3Step up onto the first stair tread with the left leg.
- 4Shift body weight from the crutches onto the left leg.
- 5Lift the crutches and the right leg simultaneously to the stair tread.
Answer
The correct sequence for ascending stairs is to establish a tripod base, shift weight to the crutches, step up with the unaffected (left) leg, transfer weight to the left leg, and finally bring the crutches and the affected (right) leg up.
When a client is non-weight-bearing on one leg, they must utilize a three-point crutch gait. The standard clinical mnemonic 'up with the good, down with the bad' applies to negotiating stairs. To safely ascend, the client must first establish a stable tripod stance and support their weight entirely with the crutches. This allows them to safely lift their strong, unaffected (left) leg onto the next step. Once the strong leg is securely planted, the client shifts their center of gravity and weight onto it. The strong leg then performs the work of lifting the body, which allows the client to bring the crutches and the affected (right) leg up to the step simultaneously without bearing any weight on the injured limb.
Step-by-Step Solution
Key Concept
Assistive Devices and Mobility: Crutch Walking (Three-Point Gait)