CHAPTER 22:2 AMBULATING PATIENTS WHO USE TRANSFER (GAIT) BELTS, CRUTCHES, CANES, OR WALKERS

Transcription

1 CHAPTER : AMBULATING PATIENTS WHO USE TRANSFER (GAIT) BELTS, CRUTCHES, CANES, OR WALKERS ASSIGNMENT SHEET Grade Name INTRODUCTION: This assignment will help you review the main facts on ambulation aids. INSTRUCTIONS: Review the information on Ambulating Patients Who Use Transfer (Gait) Belts, Crutches, Canes, or Walkers. In the space provided, print the word(s) that best completes the statement or answers the question. 1. What type of grasp should be used with a transfer belt? Why?. Identify the following types of crutches: a. crutches that are used for short periods of time and require that the patient bear weight on the hand bars instead of the axillary supports: b. crutches that require the patient to flex the elbows at a right angle so he or she can bear weight on the forearm: c. crutches for patients who cannot grip handles or bear weight on the wrist or hands:. When a patient is being fitted for crutches, the following measurement points should be noted: Height of heels on shoes: Position of crutches: Distance between axilla and axillary bar: inches to the side and front of the patient's foot. Degree angle for elbows:. If a patient can bear weight on both legs, the gait is usually taught first. When the patient has mastered this gait, the gait is taught next. After the patient gains strength in the arms and shoulders, faster gaits such as the _ or are taught.. If a patient can bear weight on only one leg, the first crutch gait taught is the _ When the patient gains strength in the arms and shoulders, faster gaits such as the and are taught. 009 Delmar, Cengage Learning.

2 Name 6. Why is it important to avoid putting pressure on the axillary area when fitting a patient for crutches? 7. Canes should generally be used on the side. 8. The bottom tip of a cane should be positioned a pproximately to. _ inches from the side of the unaffected foot. The cane handle should be level with. The elbow should be flexed at a/ an. degree angle while cane is being used. 9. Why are walkers with wheels dangerous? 10. What major criteria is used to determine whether a patient should use a walker? 11. Handles on a walker should be level with the. The elbows should be flexed at a/ an degree angle. 1. Why are the legs of the walker fitted with rubber tips? 1. Why is it important to caution a patient against sliding a walker? 1. You are walking a patient with a transfer belt. The patient starts to fall forward. What should you do? 009 Delmar, Cengage Learning.

3 C H A P T E R : A Evaluation Sheet Name Date Evaluated by DIRECTIONS: Practice ambulating a patient with a transfer (gait) belt according to the criteria listed. When you are ready for your final check, give this sheet to your instructor. PROFICIENT Ambulating a Patient with a Transfer (Gait) Belt 1. Checks order or obtains authorization. Assembles supplies. Introduces self, identifies patient, and explains procedure. Closes door and screens unit. Washes hands 6. Locks bed to prevent movement and lowers siderail if elevated 7. Assists patient to sitting position 8. Puts on robe 9. Applies transfer (gait) belt: Checks for correct size Places on top of clothing Positions around waist Positions buckle/ clasp slightly off center Makes sure belt is smooth and wrinkle-free 10. Tightens and closes belt correctly: Pulls belt snugly against patient Secures clasp or buckle Inserts three or four fingers under belt 11. Checks belt: Checks that belt is comfortable Checks respirations Makes sure breasts are not under belt 1. Puts on patient's shoes/slippers 1. Assists patient to standing position: Faces patient and gets broad base of support Grasps loops or places hands under sides of belt Bends at knees Gives signal for patient to stand Keeps back straight and straightens knees as patient stands Delmar, Cengage Learning.

4 :A (cont.) Ambulating a Patient with a Transfer (Gait) Belt 1. Moves to position behind patient: Supports patient in standing position Keeps one hand firmly on side of belt Moves other hand to grasp back of belt Moves second hand from side to back Moves behind patient 1. Ambulates patient with belt: Keeps firm underhand grasps on belt Walks slightly behind patient Encourages patient to walk slowly Encourages patient to use handrails 16. Assists patient if patient starts to fall: Keeps firm grip on belt Braces patient with body Eases patient slowly to floor Protects patient's head Calls for help but remains with patient Makes no attempt to get patient up until help arrives 17. Returns patient to bed after ambulation 18. Removes belt 19. Checks patient for following points before leaving: Patient in correct alignment 1 Siderails elevated if indicated 1 Bed at lowest level 1 Call signal and supplies within reach 1 Area neat and clean 1 0. Replaces all equipment used 1. Washes hands. Records or reports all required information Totals 100 Final Check: Instructor or authorized person evaluates. Earned: possible times each "yes" check Delmar, Cengage Learning.

5 C H A P T E R : B E v a I u a t i o n Sheet Name Date ( Evaluated by DIRECTIONS: Practice ambulating a patient with crutches according to the criteria listed. When you are ready for your final check, give this sheet to your instructor. PROFICIENT Ambulating a Patient Who Uses Crutches 1. Checks order or obtains authorization. Assembles equipment and supplies. Checks rubber tips on ends. Checks padding on axillary bar and hand rest. Introduces self, identifies patient, and explains procedure 6. Washes hands 7. Assists patient in putting on shoes: Low, broad heel Heel 1-11/ inches high Nonskid soles 8. Puts transfer (gait) belt on patient, assists patient to standing position, and positions crutches 9. Checks measurement of crutches for following points: Crutches -6 inches in front of feet Crutches -6 inches in side of feet -inch gap between axilla and bar Elbow flexed at -0 angle 10. Assists with four-point gait: Moves right crutch forward Moves left foot forward Moves left crutch forward Moves right foot forward 11. Assists with three-point gait: Advances both crutches and affected foot Transfers body weight forward to crutches Advances unaffected foot 009 Delmar, Cengage Learning. 7

6 :B (cont.) Ambulating a Patient Who Uses Crutches 1. Assists with two-point gait: Moves right foot and left crutch forward together Moves left foot and right crutch forward together 1. Assists with swing-to gait: Balances weight on foot/feet Moves both crutches forward Transfers weight forward Swings feet up to crutches 1. Assists with swing-through gait: Balances weight on foot/feet Advances both crutches Transfers weight forward Swings feet up to and through crutches Stops slightly in front of crutches 1. Checks that patient does not rest weight on axillary rest or bar 16. Limits distances so patient does not move too far at one time 17. Removes transfer belt, positions patient comfortably, and observes safety checks when ambulation is complete 18. Replaces equipment 19. Washes hands 0. Records or reports required information Totals 100 Final Check: Instructor or authorized person evaluates. Earned: possible times each "yes" check Delmar, Cengage Learning.

7 C H A P T E R : C Evaluation Sheet Name Date Evaluated by DIRECTIONS: Practice ambulating a patient using a cane according to the criteria listed. When you are ready for your final check, give this sheet to your instructor. PROFICIENT Ambulating a Patient Who Uses a Cane 1. Checks order or obtains authorization. Assembles equipment and supplies. Checks rubber suction tip. Introduces self, identifies patient, and explains procedure. Washes hands 6. Assists patient in putting on shoes: Low, broad heel Heel1-11! inches high Nonskid soles 7. Puts transfer (gait) belt on patient, assists patient to standing position, and positions cane 8. Checks measurement of cane for following points: Positions cane 6-10 inches from side of unaffected foot Top of cane at top of femur at hip joint Elbow flexed at -0 angle 9. Tells patient to use cane on unaffected side 10. Assists patient with three-point gait: Balances weight on unaffected foot Moves cane forward Moves affected foot forward Transfers weight forward to cane Moves unaffected foot forward 11. Assists patient with two-point gait: Balances weight on unaffected foot Moves cane and affected foot forward Keeps cane close to body Transfers weight forward to cane Moves unaffected foot forward 1. Remains alert at all times and watches patient closely to ensure that patient maintains balance 1. Assists patient on steps: Steps first with unaffected foot Follows with cane and affected foot 009 Delmar, Cengage Learning. 9

8 :C (cont.) Ambulating a Patient Who Uses a Cane Final Check 1. Gives verbal clues to assist patient in performing proper gait pattern 1. Removes transfer belt, positions patient comfortably, and observes safety checks when arnbulation is complete 16. Replaces equipment 17. Washes hands 18. Records or reports patient's progress and any problems noted Totals 100 Final Check: Instructor or authorized person evaluates. Earned: possible times each "yes" check. 009 Delmar, Cengage Learning. 1

9 C H A P T E R : D Evaluation Sheet Name Date Evaluated by DIRECTIONS: Practice ambulating a patient using a walker according to the criteria listed. When you are ready for your final check, give this sheet to your instructor. PROFICIENT Ambulating a Patient Who Uses a Walker l. Checks order or obtains authorization. Assembles equipment and supplies. Checks walker for following points: Rubber suction tips secure No rough or damaged edges on hand rests. Introduces self, identifies patient, and explains procedure. Washes hands 6. Assists patient in putting on shoes: Low, broad heel Heel 1-1 Y inches high Nonskid soles 7. Puts transfer (gait) belt on patient, assists patient to standing position, positions walker, and asks patient to grasp hand rests securely 8. Checks height of walker for following points: Hand rests at level of top of femur at hip joint Elbows flexed at -0 angle 9. Starts with patient standing inside walker Tells patient to lift walker forward so back legs are even with patient's toes Cautions patient against sliding walker 6 1. Tells patient to transfer weight slightly forward to walker 6 1. Tells patient to use walker for support while walking into walker 6 1. Walks to side and slightly behind patient 1. Remains alert and watches patient closely to ensure that patient maintains balance 009 Delmar, Cengage Learning.

10 :D (cont.) Ambulating a Patient Who Uses a Walker 16. Checks that patient is lifting walker 17. Checks that patient is placing walker just to toes 18. Positions patient comfortably, removes transfer belt, and observes safety checks when ambulation is complete 19. Replaces all equipment 0. Washes hands 1. Records or reports patient's progress and any problems noted Totals 100 Final Check: Instructor or authorized person evaluates. Earned: possible times each "yes" check. 009 Delmar, Cengage Learning.