1. Assisting with Ambulation Teresa V. Hurley, MSN, RN

2. Dangling a Client  Prevent injury  Seated position at side of bed with feet touching the floor  Gaze looking forward  What is orthostatic hypotension?

3. Ambulation  Stand erect  Gaze forward  Heel to toe  Opposite arm swing to opposite leg

4. Nursing Assistance  One Nurse Assist  Two Nurse Assist

5. Special Consideration  Client has one-sided weakness or paralysis  Nurse stands on the weaker or affected side  With arm around waist to stabilize the client

6. Preventing Injury: Falls  Client begins to fall or feels faint  What are you going to do?

7. Nurse Guides to Floor  Move hip forward closest to client with a wide base of support and have client slide down your leg into a sitting or lying position

8. Walking Assistive Devices  Canes  Walkers  Braces  Walking belts

9. Canes  Single-ended curve ended ideal for use with stairs  Single-ended straight ended used when balance is intact and hand weakness exists  Multi-prong used when there is balance problems because it has a wide base of support

10. Canes  Rubber tipped  Sizing: bottom 4 inches to side of foot  Sizing: top reaches hip joint  Held with stronger side with elbow bent at 30 degree angle  Weight evenly distributed  Advance weaker leg and cane simultaneously  Swing stronger leg  Avoid leaning forward

11. Walkers  Client picks up walker and advances as steps ahead  Impaired side advances first ahead after picks up walker

12. Braces  Support joints and muscles that can not support body weight

13. Crutches  Reliance on strength of arms and shoulders  Limit or eliminate weight bearing  Forearm Support Crutches used for permanent limitations  Axillary Crutches used for short or long term

14. Axillary Crutches  Body weight carried on arms and hands and not axilla  2 Point Gait and 4 Point Gait used for partial weight bearing  3 Point Gait non-weight bearing  Swing to and Swing through for weight bearing  Upstairs lead with unaffected and going down stairs lead with effected

15. Crutches  Measure by lying flat in bed with shoes used for walking Measure from anterior fold of axilla to the heel and add 1 inch = 2.5 cm Standing position: crutch pad should be three finger breaths from anterior fold of axilla