Author Question: A nurse assists a client with left-sided weakness to walk with a cane. What is the correct order of ... (Read 78 times)

Mr3Hunna · **on:** Jun 25, 2018

A nurse assists a client with left-sided weakness to walk with a cane. What is the correct order of steps for gait training with a cane?

1. Apply a transfer belt around the client's waist.
2. Move the cane and left leg forward at the same time.
3. Guide the client to a standing position.
4. Move the right leg one step forward.
5. Place the cane in the client's right hand.
6. Check balance and repeat the sequence.
a.
3, 1, 5, 4, 2, 6
b.
1, 3, 5, 2, 4, 6
c.
5, 3, 1, 2, 4, 6
d.
3, 5, 1, 4, 2, 6

Question 2

A nurse assesses a client who is admitted with hip problems. The client asks, Why are you asking about my bowels and bladder? How should the nurse respond?

a. To plan your care based on your normal elimination routine.
b. So we can help prevent side effects of your medications.
c. We need to evaluate your ability to function independently.
d. To schedule your activities around your elimination pattern.

durant1234 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
To ambulate a client with a cane, the nurse should first apply a transfer belt around the client's waist, then guide the client to a standing position and place the cane in the client's strong hand. Next the nurse should assist the client to move the cane and weaker leg forward together. Then move the stronger leg forward and check balance before repeating the sequence.

Answer to Question 2

ANS: A
Bowel elimination varies from client to client and must be evaluated on the basis of the client's normal routine. The nurse asks about bowel and bladder habits to develop a client-centered plan of care. The other answers are correct but are not the best responses. Oral analgesics may cause constipation, but they do not interfere with bladder control. The client is in rehabilitation to assist his or her ability to function independently. Elimination usually is scheduled around rehabilitation activities but should be taken into consideration when a plan of care is developed.