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Zorluk: OrtaBasic Care and Comfort

An older adult client who recently experienced a cerebrovascular accident has residual left-sided hemiparesis. The practical nurse is helping the client put on a clean, front-buttoning shirt. In what order should the nurse complete the following actions? Arrange the steps in the correct sequence from first to last.

  1. 1Assist the client to a safe, upright seated position on the edge of the bed or in a chair.
  2. 2Gather the left sleeve of the shirt and slide it gently over the client's left arm.
  3. 3Pull the body of the shirt carefully across the client's back toward the right side.
  4. 4Instruct the client to insert their right arm into the right sleeve.
  5. 5Fasten the front buttons of the shirt and smooth out any fabric wrinkles.

Cevap

The correct sequence is to first sit the client upright, dress the weak left arm, pull the shirt around the back, have the client insert their strong right arm, and finally button the shirt.
The correct sequence prioritizes client safety by first establishing a secure seated position. When dressing a client with unilateral weakness (hemiparesis), the cardinal clinical rule is to dress the affected or weaker side first. This minimizes the need to move or stretch the impaired limb, thereby reducing the risk of joint injury and pain. After the weak arm (left) is dressed, the shirt is brought around the back, allowing the client to use their unaffected arm (right) to independently slide into the remaining sleeve. Finally, securing the buttons and smoothing the fabric completes the process and prevents pressure from wrinkled clothing.

Adım Adım Çözüm

1
Assist the client to a safe, upright seated position.
The client is stable and ready for the activity.
Establishing a secure position is the primary safety priority before initiating any activities of daily living.
2
Slide the left sleeve over the client's left arm.
The affected side is dressed.
Dressing the weaker side first (left side, due to left-sided hemiparesis) prevents overextension and potential injury to the affected shoulder and arm.
3
Pull the shirt across the client's back toward the right side.
The shirt is positioned for the strong arm.
This transitions the garment securely so the client can use their unaffected side for the next step.
4
Instruct the client to insert their right arm into the right sleeve.
The strong side is dressed.
The unaffected arm has the mobility to reach and push through the sleeve without requiring excessive manipulation.
5
Fasten the buttons and smooth out wrinkles.
The dressing process is complete.
Properly securing the clothing provides warmth and dignity, while smoothing fabric prevents friction and skin breakdown.

Anahtar Kavram

Activities of Daily Living (ADLs): Dressing a Client with Hemiparesis
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