ppt chapter 26
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Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 26 Ambulatory Aids
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Question
•Is the following statement true or false?
Gluteal setting is a type of isometric exercise in which the client alternately tenses and relaxes the quadriceps muscles.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Answer
False.
Quadriceps setting is the isometric exercise in which the client alternately tenses and relaxes the quadriceps muscles.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Preparing for Ambulation
• Isometric exercises:– Quadriceps setting: client alternately
tenses and relaxes the quadriceps muscles
– Gluteal setting: client contracts and relaxes the gluteal muscles to strengthen and tone them
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Quadriceps and Gluteal Setting Exercises
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• Upper arm strengthening: flexion and extension of the arms and wrists; raising and lowering weights with the hands; squeezing a ball or spring grip; modified hand push-ups in bed
• Dangling: normalizes blood pressure
• Using a tilt table
Preparing for Ambulation
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Assistive Devices
• Devices to support and assist walking:
– Parallel bars (handrails) provide practice in ambulating
– Walking belt applied around client’s waist provides secure grip to prevent injury while ambulating
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Ambulatory Aids• Crutches: generally used in pairs and made
of wood or aluminum
– Axillary
– Forearm
– Platform
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Ambulatory Aids (Cont’d)
• Cane: a hand-held ambulation device made of wood or aluminum
– Rubber tips reduce possibility of slipping
• Walker: most stable device; has curved aluminum bars and three-sided enclosure with four legs for support
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Ambulatory Aids (cont’d)• Crutch-walking gaits: pattern of walking
when ambulating with crutches
– Four-point gait
– Three-point gait
– Two-point gait
– Swing-through gait
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Using a Cane
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Crutch-Walking Gaits
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Question•Which of the following ambulatory aids are
used mostly by clients who are diagnosed with arthritis of the hands or wrists?
a. Canesb. Auxiliary crutchesc. Walkersd. Forearm crutches
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Answer
d. Forearm crutches
The use of crutches requires a great deal of upper arm strength; hence, forearm crutches are used by clients who have arthritis of the hands or wrists since weight is placed upon forearms.
Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins
Measuring for Crutches, Canes, and Walkers
(Refer to Skill 26-1 in the textbook.)
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Assisting With Crutch-Walking
(Refer to Skill 26-2 in the textbook.)
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Prosthetic Limbs
• Temporary prosthetic limb: immediate postoperative prosthesis (IPOP)
• Permanent prosthetic components delayed for several weeks or months to be sure:
– Incision has healed
– Stump size is relatively stable
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Prosthetic Limbs (cont’d)
• Prosthetic components include:– Below the knee: socket, shank,
ankle/foot system– Above the knee: below-the-knee
components plus a knee system• Ambulation with a lower limb prosthesis
requires strength and endurance
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Applying a Leg Prosthesis
(Refer to Skill 26-3 in the textbook.)
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Question
•Is the following statement true or false?
Amputees should avoid strenuous activities, as these can lead to further complications.
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Answer
False.
Amputees can take up strenuous activities such as snow skiing if they use a sturdier modified prosthesis.
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Nursing Implications • Nursing diagnoses include:
– Impaired physical mobility– Risk for disuse syndrome, trauma– Unilateral neglect– Risk for activity intolerance – Risk for peripheral neurovascular
dysfunction
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General Gerontologic Considerations• Functional ability involves mobility and
making adaptations to compensate for changes occurring with aging or disease processes
• May need encouragement and support integrating adaptations into their activities of daily living and maintaining their self-concept and body image
• Maintaining independence is important to older adults
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General Gerontologic Considerations (cont’d)
• Mobility facilitates staying active and independent
• As a person ages, he or she may develop flexion of the spine which alters the center of gravity and may increase falls
• Ensure adequate lighting without laying electric cords in passageways
• Elevate toilet seats; install grab bars• Rearrange home furnishings
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