Editing Fundamentals of Nursing – LPN Flashcards (section)

== Mobility, transfers, and fall safety ==

;How is a gait belt used correctly?
:Apply it snugly around the waist over clothing, grasp it from underneath with both hands, keep the patient close to your center of gravity, and walk slightly behind and toward the patient's weaker side. Never lift a patient by the arms or under the axillae.

;On which side is a cane held, and in what sequence is it advanced?
:On the strong or unaffected side. Advance the cane and the weak leg together, then step through with the strong leg. The cane is held close to the body, and the patient stands upright rather than leaning over it.

;What is the rule for stairs with an assistive device?
:The strong leg goes up first and the weak leg goes down first, remembered as "up with the good, down with the bad." The cane or crutches move with the weak leg.

;How is a standard walker used, and where should weight be borne on crutches?
:The standard walker is lifted and set down about one step ahead with all four legs on the floor, then the patient steps into it without leaning over it or pulling up on it to stand. With crutches, weight is borne on the hands, not the axillae, and the axillary pad sits two to three finger widths below the axilla to prevent nerve injury.

;Toward which side should a patient be transferred, and what is checked first?
:Toward the stronger side. Lock the wheels, lower the bed, place the chair at a slight angle on the strong side, and dangle the patient at the bedside first to check for dizziness or orthostatic symptoms before standing.

;What are the key principles of body mechanics?
:Widen your base of support, bend at the knees and hips rather than the waist, keep the load close to your body, pivot your feet instead of twisting, push rather than pull when possible, raise the bed to waist height, and get help or a mechanical lift for dependent patients.

;What should you do if a patient begins to fall while you are assisting?
:Do not try to hold the patient upright. Widen your stance, pull the patient close, protect the head, and ease the patient down along your leg to the floor. Then call for help, stay with the patient, and do not move the patient until an assessment is done.

;How often are patients repositioned, and how are heels protected?
:At least every two hours in bed and at least every hour in a chair. Place pillows lengthwise under the calves so the heels float completely off the mattress. Never massage a reddened bony prominence and never use a donut cushion.

;What do the Fowler positions and the Sims position mean?
:Low or semi Fowler is 30 to 45 degrees, Fowler is 45 to 60 degrees, and high Fowler is 60 to 90 degrees, which best supports lung expansion and eating. Sims is a semiprone left side lying position with the upper leg flexed, used for enemas and rectal suppositories.