A client who recently experienced a cerebrovascular accident has new-onset right-sided hemiparesis. The nurse is preparing to transfer the client from the bed to a wheelchair using a stand-and-pivot technique. The client is currently resting supine in bed. Place the following steps in the correct chronological order to ensure a safe transfer.
- 1Position the wheelchair on the client's left side at a 45-degree angle to the bed and lock the brakes.
- 2Elevate the head of the bed and assist the client to sit on the edge of the mattress.
- 3Apply non-skid footwear and secure a transfer belt snugly around the client's waist.
- 4Instruct the client to lean forward and push down on the mattress with their left hand to stand.
- 5Guide the client to pivot on their unaffected leg and reach for the wheelchair armrest before sitting.
Answer
The correct sequence begins with preparing the environment by placing the wheelchair on the strong side, assisting the client to sit, applying safety gear, assisting to stand using the strong arm, and finally pivoting on the strong leg to sit in the wheelchair.
Safe transfer of a client with hemiparesis requires strict adherence to biomechanical principles and environmental safety. The wheelchair must always be positioned on the unaffected (strong) side so the client can use their functional limbs to bear weight and stabilize themselves. The client must first be assisted to a sitting position before the transfer belt is applied to ensure a proper fit. Finally, standing and pivoting rely on the strength of the unaffected leg and arm to safely transition into the chair.
Step-by-Step Solution
Key Concept
Safe Client Transfer Techniques and Hemiparesis Mobility