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Walker: Assisting The Patient

Walkers are devices that provide more support than a cane for ambulatory clients who lack strength and balance for crutches. Nurses must ensure walkers are at the proper height and assist patients in safely using walkers by having them lift and move the walker forward in small steps alternating between their strong and weak sides. Canes provide support during ambulation and transfers for clients with weakness, instability, or balance issues and require nurses to ensure proper fitting and technique with tips replaced as needed. Crutches are commonly used by younger clients with arm strength after injuries and require nurses to properly measure and fit crutches, instruct clients on safe technique for ambulation and stairs, and ensure regular inspection of tips.

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Chin Villanueva Ulam
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299 views4 pages

Walker: Assisting The Patient

Walkers are devices that provide more support than a cane for ambulatory clients who lack strength and balance for crutches. Nurses must ensure walkers are at the proper height and assist patients in safely using walkers by having them lift and move the walker forward in small steps alternating between their strong and weak sides. Canes provide support during ambulation and transfers for clients with weakness, instability, or balance issues and require nurses to ensure proper fitting and technique with tips replaced as needed. Crutches are commonly used by younger clients with arm strength after injuries and require nurses to properly measure and fit crutches, instruct clients on safe technique for ambulation and stairs, and ensure regular inspection of tips.

Uploaded by

Chin Villanueva Ulam
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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WALKER

Walkers are mechanical devices for ambulatory clients who need more support than a cane
provides and lack the strength and balance required for crutches.

Assisting the patient

1. Wash your hands


2. Identify the patient and introduce yourself
3. Explain what you are going to do
4. Lower bed to lowest level and assist patient to sit on edge of the bed
5. Assist patient in putting on nonskid shoes and socks
6. Apply gait belt
7. Stand in the weak side of the patient

How to use walker

1. First, tell the patient to lift and move the walker 6 inches forward.
2. Then move the WEAK side forward.
3. Then move the STRONG side forward.
4. Repeat.

Nursing responsibility

1. Ensure the safety of the patient by the use of gait belt


2. Make sure all the 4 legs of the walker are level on the ground
3. Check the rubber tips on the legs of the walker often and replace the tips when they become
over worn.
4. Advice patient to use walker slowly in tiled floors
5. Always stand in the weaker side of the patient
6. Advice patient not to lean forward over the walker to keep good posture.
CANE
An assistive device prescribed to provide support during ambulation and transfers for individuals with
weakness, instability, pain, or balance loss.

USING CANE:

1. Hold the cane with the hand on the stronger side of the body to provide maximum support and
appropriate body alignment when walking.
2. Position the tip of a standard cane ( and the nearest tip of the canes about 15 cm (6 in) in front
of the near foot, so that the elbow is slightly flexed.

WHEN MAXIMUM SUPPORT IS REQUIRED

1. Move the cane forward about 30 cm (1ft), or a distance that is comfortable while the body is
borne by both legs.
2. Then Move the affected (weak) leg forward to the cane while the weight is borne by the cane
and stronger leg.
3. Next, move the unaffected (Stronger) leg forward ahead of the cane and weak leg while the
weight is borne by the cane and weak leg
4. Repeat the steps. This pattern of moving provides at least to points of support on the floor at
all times.

Nursing responsibility

1. Ensure the safety of the patient by the use of gait belt


2. Make sure the legs of the canes are level on the ground
3. Check the rubber tips on the leg of the cane often and replace the tips when they become over
worn.
4. Advice patient to use cane slowly in tiled floors
5. Always stand in the weaker side of the patient
CRUTCHES
Crutches are used most often for younger clients who have good upper arm strength who have been
affected with an acute musculoskeletal injury such as a sprain, strain or fracture.

Measuring Clients for Crutches

1. The client lies in a supine position and the nurse measures from the anterior folds of the axilla to
the heel of the foot and adds 2.5cm (1in)

2. The client stands erect and position the crutch. The nurse makes sure the shoulder rest of the
crutch is at least three finger widths, that is 2.5cm to 5 cm (1 to 2 in), below the axilla

To determine the correct placement of the hand bar:

1. The client stands upright and supports the body weight hand grips of the crutches.

2. The nurse measures the angle of elbow flexion. It should be about 30 degrees. A goniometer may
be used to verify the correct angle.

CLIENT TEACHING

1. Follow the plan of exercise developed for you to strengthen your arm muscles before
beginning crutch walking
2. Have a health care professional establish the correct length for your crutches and the correct
placement of the hand pieces. Crutches that are too long force your shoulder upward and
make is difficult for you to push your body off the ground. Crutches that are too short will make
you hunch over and develop an improper stance.
3. The weight of your body should be borne by the arms rather than the axillae (armpits).
Continual pressure on the axillae can injure the radial nerve and eventually cause crutch palsy,
a weakness of the muscle of the forearm, wrist and hand.
4. Maintain an erect posture as much as possible to prevent strain on muscles and joints to
maintain balance.
5. Each step taken with crutches should be a comfortable distance for you. It is wise to start with
a small rather than a large step.
6. Inspect the crutch tips regularly, and replace them if worn.
7. Keep the crutch tips dry and clean to maintain their surface friction. If the tips become wet, dry
them well before use.
8. Wear a shoe with a low heel that grips the floor. Rubber soles decrease the changes of
slipping. Adjust shoelaces so they cannot come unties or reach the floor where they might
catch on the crutches. Consider shoes with alternative forms of closure (e.g Velcro), especially
if you cannot easily bend to tie laces. Slip-on shoes are acceptable only if they are snug and
the heel does not come loose when the foot is bent.
Going up Stairs

1. For this procedure, the nurse stands behind the client and slightly to the affected side if
needed. The nurse instructs the client to:
2. Assume the tripod position at the bottom of the stairs.
3. Transfer the body weight to the crutches and move the unaffected leg onto the step.
4. Transfer the body weight to the unaffected leg on the step and move the crutches and affected
leg to the step. The affected leg is always supported by the crutches.
5. Repeat steps 2 and 3 until the client reaches the top of the stairs.

Going Down The Stairs

1. For this procedure, the nurse stands one step below the client on the affected side if needed.
The nurses instructs the client to:
2. Assume the tripod position at the top of the stairs.
3. Shift the body weight to the unaffected leg and move the crutches and affected leg down onto
the next step.
4. Transfer the body weight to the crutches, and move the unaffected leg to the step. The
affected leg is always supported by the crutches.
5. Repeat steps 2 and 3 until the client reaches the bottom of the stairs.

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