ppt chapter 26

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Chapter 26 Ambulatory Aids


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.


Answer

False.

Quadriceps setting is the isometric exercise in which the client alternately tenses and relaxes the quadriceps muscles.


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


Quadriceps and Gluteal Setting Exercises


• 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


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


Ambulatory Aids• Crutches: generally used in pairs and made

of wood or aluminum

– Axillary

– Forearm

– Platform


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


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


Using a Cane


Crutch-Walking Gaits


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


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.


Measuring for Crutches, Canes, and Walkers

(Refer to Skill 26-1 in the textbook.)


Assisting With Crutch-Walking



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


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


Applying a Leg Prosthesis



Question

•Is the following statement true or false?

Amputees should avoid strenuous activities, as these can lead to further complications.


Answer

False.

Amputees can take up strenuous activities such as snow skiing if they use a sturdier modified prosthesis.


Nursing Implications • Nursing diagnoses include:

– Impaired physical mobility– Risk for disuse syndrome, trauma– Unilateral neglect– Risk for activity intolerance – Risk for peripheral neurovascular

dysfunction


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


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

ppt chapter 26

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