Ppt chapter 26

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Ppt chapter 26

  1. 1. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 26 Ambulatory Aids
  2. 2. 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.
  3. 3. 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.
  4. 4. 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
  5. 5. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Quadriceps and Gluteal Setting Exercises
  6. 6. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins • 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
  7. 7. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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
  8. 8. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Ambulatory Aids • Crutches: generally used in pairs and made of wood or aluminum – Axillary – Forearm – Platform
  9. 9. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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
  10. 10. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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
  11. 11. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Using a Cane
  12. 12. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Crutch-Walking Gaits
  13. 13. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Which of the following ambulatory aids are used mostly by clients who are diagnosed with arthritis of the hands or wrists? a. Canes b. Auxiliary crutches c. Walkers d. Forearm crutches
  14. 14. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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.
  15. 15. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Measuring for Crutches, Canes, and Walkers (Refer to Skill 26-1 in the textbook.)
  16. 16. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Assisting With Crutch-Walking (Refer to Skill 26-2 in the textbook.)
  17. 17. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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
  18. 18. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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
  19. 19. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Applying a Leg Prosthesis (Refer to Skill 26-3 in the textbook.)
  20. 20. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Question •Is the following statement true or false? Amputees should avoid strenuous activities, as these can lead to further complications.
  21. 21. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Amputees can take up strenuous activities such as snow skiing if they use a sturdier modified prosthesis.
  22. 22. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Implications • Nursing diagnoses include: – Impaired physical mobility – Risk for disuse syndrome, trauma – Unilateral neglect – Risk for activity intolerance – Risk for peripheral neurovascular dysfunction
  23. 23. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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
  24. 24. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins 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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