Ch 26 ambulatory aids


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Ch 26 ambulatory aids

  1. 1. Chapter 26 Ambulatory Aids
  2. 2. Question <ul><li>Is the following statement true or false? </li></ul><ul><li>Gluteal setting is a type of isometric exercise in which the client alternately tenses and relaxes the quadriceps muscles. </li></ul>
  3. 3. Answer False. Quadriceps setting is the isometric exercise in which the client alternately tenses and relaxes the quadriceps muscles.
  4. 4. Preparing for Ambulation <ul><li>Isometric exercises: </li></ul><ul><ul><li>Quadriceps setting: client alternately tenses and relaxes the quadriceps muscles </li></ul></ul><ul><ul><li>Gluteal setting: client contracts and relaxes the gluteal muscles to strengthen and tone them </li></ul></ul>
  5. 5. Quadriceps and Gluteal Setting Exercises
  6. 6. <ul><li>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 </li></ul><ul><li>Dangling: normalizes blood pressure </li></ul><ul><li>Using a tilt table </li></ul>Preparing for Ambulation
  7. 7. Assistive Devices <ul><li>Devices to support and assist walking: </li></ul><ul><ul><li>Parallel bars (handrails) provide practice in ambulating </li></ul></ul><ul><ul><li>Walking belt applied around client’s waist provides secure grip to prevent injury while ambulating </li></ul></ul>
  8. 8. Ambulatory Aids <ul><li>Crutches: generally used in pairs and made of wood or aluminum </li></ul><ul><ul><li>Axillary </li></ul></ul><ul><ul><li>Forearm </li></ul></ul><ul><ul><li>Platform </li></ul></ul>
  9. 9. Ambulatory Aids (Cont’d) <ul><li>Cane: a hand-held ambulation device made of wood or aluminum </li></ul><ul><ul><li>Rubber tips reduce possibility of slipping </li></ul></ul><ul><li>Walker: most stable device; has curved aluminum bars and three-sided enclosure with four legs for support </li></ul>
  10. 10. Ambulatory Aids (cont’d) <ul><li>Crutch-walking gaits: pattern of walking when ambulating with crutches </li></ul><ul><ul><li>Four-point gait </li></ul></ul><ul><ul><li>Three-point gait </li></ul></ul><ul><ul><li>Two-point gait </li></ul></ul><ul><ul><li>Swing-through gait </li></ul></ul>
  11. 11. Using a Cane
  12. 12. Crutch-Walking Gaits
  13. 13. Question <ul><li>Which of the following ambulatory aids are used mostly by clients who are diagnosed with arthritis of the hands or wrists? </li></ul><ul><li>a. Canes </li></ul><ul><li>b. Auxiliary crutches </li></ul><ul><li>c. Walkers </li></ul><ul><li>d. Forearm crutches </li></ul>
  14. 14. Answer <ul><li>d. Forearm crutches </li></ul><ul><li>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. </li></ul>
  15. 15. Measuring for Crutches, Canes, and Walkers (Refer to Skill 26-1 in the textbook.)
  16. 16. Assisting With Crutch-Walking (Refer to Skill 26-2 in the textbook.)
  17. 17. Prosthetic Limbs <ul><li>Temporary prosthetic limb: immediate postoperative prosthesis (IPOP) </li></ul><ul><li>Permanent prosthetic components delayed for several weeks or months to be sure: </li></ul><ul><ul><li>Incision has healed </li></ul></ul><ul><ul><li>Stump size is relatively stable </li></ul></ul>
  18. 18. Prosthetic Limbs (cont’d) <ul><li>Prosthetic components include: </li></ul><ul><ul><li>Below the knee: socket, shank, ankle/foot system </li></ul></ul><ul><ul><li>Above the knee: below-the-knee components plus a knee system </li></ul></ul><ul><li>Ambulation with a lower limb prosthesis requires strength and endurance </li></ul>
  19. 19. Applying a Leg Prosthesis (Refer to Skill 26-3 in the textbook.)
  20. 20. Question <ul><li>Is the following statement true or false? </li></ul><ul><li>Amputees should avoid strenuous activities, as these can lead to further complications. </li></ul>
  21. 21. Answer <ul><li>False. </li></ul><ul><li>Amputees can take up strenuous activities such as snow skiing if they use a sturdier modified prosthesis. </li></ul>
  22. 22. Nursing Implications <ul><li>Nursing diagnoses include: </li></ul><ul><ul><li>Impaired physical mobility </li></ul></ul><ul><ul><li>Risk for disuse syndrome, trauma </li></ul></ul><ul><ul><li>Unilateral neglect </li></ul></ul><ul><ul><li>Risk for activity intolerance </li></ul></ul><ul><ul><li>Risk for peripheral neurovascular dysfunction </li></ul></ul>
  23. 23. General Gerontologic Considerations <ul><li>Functional ability involves mobility and making adaptations to compensate for changes occurring with aging or disease processes </li></ul><ul><li>May need encouragement and support integrating adaptations into their activities of daily living and maintaining their self-concept and body image </li></ul><ul><li>Maintaining independence is important to older adults </li></ul>
  24. 24. General Gerontologic Considerations (cont’d) <ul><li>Mobility facilitates staying active and independent </li></ul><ul><li>As a person ages, he or she may develop flexion of the spine which alters the center of gravity and may increase falls </li></ul><ul><li>Ensure adequate lighting without laying electric cords in passageways </li></ul><ul><li>Elevate toilet seats; install grab bars </li></ul><ul><li>Rearrange home furnishings </li></ul>