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Zorluk: OrtaBasic Care and Comfort

A healthcare provider prescribes moving a client with left-sided lower extremity weakness out of bed for the first time. In what sequence should the nurse perform the following actions to safely transfer the client from the bed to a wheelchair? (Arrange the items in the correct chronological order, from first to last.)

  1. 1Position the wheelchair at a 45-degree angle to the bed on the client's right side.
  2. 2Lock the wheel brakes on both the bed and the wheelchair.
  3. 3Assist the client to a sitting position on the edge of the bed and assess for dizziness.
  4. 4Apply a gait belt securely around the client's waist.
  5. 5Instruct the client to bear weight on the right leg and pivot into the wheelchair.

Cevap

The correct sequence ensures environmental safety is established first (positioning and locking), followed by physiological safety (assessing for dizziness), mechanical safety (gait belt), and finally the physical transfer using the client's strong side.
Safe transfer protocols dictate preparing the environment first by optimizing placement and locking equipment. Next, the nurse must ensure the client is physiologically stable by addressing orthostatic hypotension. Then, the nurse applies safety equipment (gait belt) before executing the physical weight-bearing and pivot maneuver toward the client's unaffected side.

Adım Adım Çözüm

1
Position the wheelchair on the client's strong (right) side.
The wheelchair is properly aligned for a safe transfer.
Transferring toward the strong side allows the client to use their unaffected leg to bear weight and pivot, reducing the risk of collapse.
2
Lock the brakes on the bed and wheelchair.
The transfer surfaces are immobilized.
Unsecured equipment can roll away during the weight shift, leading to a fall.
3
Assist to a sitting position and allow legs to dangle while checking for dizziness.
The client adapts to the upright position.
This prevents orthostatic hypotension, a common risk for clients who have been on bed rest.
4
Apply a gait belt.
The nurse has a safe grasping point.
A gait belt lowers the risk of injury to both the nurse and the client by providing a mechanical advantage at the client's center of gravity.
5
Perform the stand-and-pivot maneuver.
The client is successfully seated in the wheelchair.
With all safety measures in place, the client uses their strong right leg to pivot into the chair safely.

Anahtar Kavram

Safe Client Transfers and Mobility
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Konular

Basic Care and Comfort

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