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Ch 26 ambulatory aids
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Ch 26 ambulatory aids



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  • 1. Chapter 26 Ambulatory Aids
  • 2. 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. Answer False. Quadriceps setting is the isometric exercise in which the client alternately tenses and relaxes the quadriceps muscles.
  • 4. 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. Quadriceps and Gluteal Setting Exercises
  • 6.
    • 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. 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. Ambulatory Aids
    • Crutches: generally used in pairs and made of wood or aluminum
      • Axillary
      • Forearm
      • Platform
  • 9. 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. 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. Using a Cane
  • 12. Crutch-Walking Gaits
  • 13. 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. 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. Measuring for Crutches, Canes, and Walkers (Refer to Skill 26-1 in the textbook.)
  • 16. Assisting With Crutch-Walking (Refer to Skill 26-2 in the textbook.)
  • 17. 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. 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. Applying a Leg Prosthesis (Refer to Skill 26-3 in the textbook.)
  • 20. Question
    • Is the following statement true or false?
    • Amputees should avoid strenuous activities, as these can lead to further complications.
  • 21. Answer
    • False.
    • Amputees can take up strenuous activities such as snow skiing if they use a sturdier modified prosthesis.
  • 22. 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. 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. 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