Hi, I'm Joanna and we're going to review
assistive devices. There are a large
variety of assistive devices. They allow
patients to ambulate and complete daily
activities of life safely. Some examples of
assistive devices include crutches,
wheelchairs, canes, walkers, shower chairs,
transfer devices, and toilet chairs.
Here are some key terms that are really
important for you to know, learn, and
understand. Practice them, write them down,
and pretend as if you're the nurse
talking to the patient, so you get comfortable
using them. Listen for these
key terms throughout this lesson, write the
definitions, practice using the words
in sentences, and visualize using the words
as a nurse. Now, we'll talk about
who needs assistive devices. Patients with
muscle weakness, temporarily after
injury or a surgical procedure, a patient
with inadequate balance or gait,
or someone with ineffective coordination.
The nursing process is
always important. Remember your assessment,
your diagnosis, and your planning.
Don't forget to implement and then evaluate
all the things that you've done.
Patients who spend a large amount of time lying or
sitting may be dizzy or weak when standing.
Never use assistive devices or transfer devices
that you have not been trained
to use. And your safety is as important as
the patient's safety. Use proper body
mechanics when transferring and assisting any patient.
Crutches are used
when a patient cannot bear full weight on a
limb. Crutches should be three
fingerbreadths of space between the pad and the
axilla. It's easy enough to measure by
taking your three fingers and placing them under
the patient's arm. The patient
must bear weight on the hands and not the armpits.
The affected leg or foot
should always be slightly in front and not behind
as some patients frequently do.
With completing patient education, don't forget
to teach them how to go up
and downstairs safely. When going up the stairs,
the patient should place the unaffected
leg on the step, then bring the crutches
up, then the affected leg last. When teaching a
patient to go down the stairs,
remember it's practically the exact
opposite of going up the stairs.
The patient should place the crutches in the
affected leg on the stair below, and then
bring down the unaffected leg. There're
variety of different gaits that we use
with the patient on crutches. The doctor
typically prescribes this and it's based
upon how much weight the patient can bear. A
two-point gait is for patients who
are able to bear partial weight. The patient
moves one foot and the opposite
crutch forward at the same time. An easy way
to remember this is to always think
the opposite. A three-point gait is for patients
who are unable to bear weight on the affected
leg or foot at all. The patient will move both
crutches and the affected leg forward
at the same time then bring the back leg forward.
A four-point gait is for patients
who are able to bear weight on the
affected limb. The patient moves each leg
in the crutch separately, one at a time.
Move the first crutch forward, then the opposite
leg of that crutch. Bring the
remaining crutch forward, followed by the
remaining leg, one at a time, starting
with the crutch always. Now, we will
review wheelchairs. Be sure to explain the
procedure and the plan to the patient
prior to beginning. Transfer the patient
from the bed to the wheelchair which may
require assistive devices or
additional personnel. Especially initially
if you're unsure of the
patient's ability to bear weight, always
have an extra pair of hands to help you.
Be sure to lock the wheelchair prior to the
transfer and position the patient properly
in the chair and avoid any pressure on bony
prominences. Here are some really
important takeaways. Patient education
Many of your questions will be centered around
this. It's most important when
you're studying this content.
Practice teaching a patient how to use assistive
devices, and know what's improper use,
such as bending their affected leg backwards,
behind the crutch. When in doubt,
always assess, diagnose, plan, and then implement.
Always assess before any
action. If two answers feel correct, choose
the best answer, and opposites attract.
If two answers are complete opposites, usually
the correct answer is in one of those.