1. Exercise, Transfers & Ambulation Nursing 125

13. Start at the Neck P&P p. 830 Neck Flexion – look @ the toes Extension – look straight ahead Hyperextension – look up @ ceiling Lateral flexion – look straight ahead, tilt head to shoulder Shoulder Flexion – raise arm forward & overhead Extension – return arm to side of body Abduction – raise arm to side to position above head with palm away from head. Adduction – return arm & bring across chest Internal rotation – elbow flexed, rotate the shoulder by moving arm til thumb is turned inward & toward the back (fingers to the floor) External rotation – elbow flexed, move arm until thumb is upward & lateral to head. (fingers point up) Circumduction – move arm in full circle (arm straight out, move hand as if to draw a circle.

14. Elbow Elbow Flexion – bend elbow Extension – straighten elbow Hyperextension – bend lower arm back as far as possible Forearm Supination – turn lower hand so palm is up Pronation - turn lower hand so palm is down Wrist Flexion – bend wrist forward Extension – straighten wrist (fingers, wrist & arm in same plane) Hyperextension – bring dorsal surface of hand as far back as possible Abduction (radial flexion) – bring wrist medially towards the thumb Adduction (ulnar flexion) – bend wrist laterally towards 5 th finger

15. Fingers & Thumb Fingers & thumb Flexion – bend fingers & thumb into palm make a fist Extension – straighten fingers & thumb Hyperextension – bend fingers as far back as possible Abduction – spread fingers apart / extend thumb laterally Adduction – bring fingers together/ thumb back to hand Circumduction – move finger/thumb in circular motion Opposition – touch thumb to each finger of same hand

16. Hip Hip Flexion – move leg forward (ROM 90-120 deg) Extension – move leg back beside other leg Hyperextension – move leg backwards (ROM 30-50 deg) Abduction – move leg laterally away from body (ROM 30-50 deg) Adduction – move leg back to medial position & beyond if possible (ROM 30-50 deg) Knee Flexion – bring heel toward back of thigh (120-130 deg) Extension – return leg to floor

17. Ankle Ankle Dorsiflexion – move foot so toes are pointed upward Plantarflexion – move foot so toes are pointed downward Foot Inversion – turn sole of foot medially (ROM 10 deg) Eversion – turn sole of foot laterally (ROM 10 deg) Flexion – curl toes downward (ROM 30-60 deg) Extension – straighten toes (ROM 30-60 deg) Abduction – spread toes apart Adduction – bring toes together

18. Spine Spine Flexion – when standing – bend forward from the waist Extension – straighten up Hyperextension – bend backward Lateral flexion – bend to the side Rotation – twist from the waist

29. Nursing Process - Transfers Assessment Activity orders Client capabilities Planning Decide appropriate transfer technique Explain procedure to the patient Implementation Wash hands Position chair 45 deg angle to bed on clients stronger side Lock bed brakes, lower bed, raise HOB as high as patient tolerates Lower side rail Assist to sitting (lift upper body & swing legs around) Assist with robe & slippers Position feet on floor Take wide stance, bend knees, grasp patient “ 1 2 3 stand ” Pivot to chair

30. Nursing Process (cont.) Evaluation Of note: Body in alignment, patient comfortable, no injuries Nurse maintains good body alignment Two person lift (same as above) except one nurse is on each side of the patient Never lift under the axilla – can damage nerves Mechanical lifts – enables you to lift heavy patients, or those unable to help. (Use 2 people)