Week 10 - Mobility and Transfers

Question 1

.

Answer 1

Safety First

1. Always use gate belt
2. Always be conscious of your body mechanics
3. Grab hold of the gate belt securely with both hands, ensure tight with no slippage.

Question 2

.

Answer 2

Don’t have to do all the work for the patient, trying to teach them to be as independent as possible.

Question 3

How do we promote independence?

Answer 3

Have the client safely do as much as possible while giving excellent verbal and/or physical cues and guarding - promotes independence.

Question 4

How do you prepare yourself for assisting with mobility activities?

Answer 4

Nurse is your friend. Do a chart review and check with nurse on patients level of activity, their most recent pain, medication schedule, and how the patient is doing physiologically and emotionally prior to stepping in the room.

Question 5

.

Answer 5

Interview Patient
Test and Measures
-Strength (how patient is able to help and assist)
-Mental Status (alert and oriented, able to fall one step and two step commands, follow sequence of instructions for motor activity)
-Range and Mobility (to actively participate)
-Any other contraindications

Question 6

Preparing the environments

Answer 6

consider the equipment that may be need

• sliding board
• hydrolic or numatic lift
• do you need the patient to assist with the rail of their bed
• what kind of tubes, catheters could interfere with transfer

Question 7

Preparing Wheelchair

Answer 7

Lock heel chair
Remove Arm Rest
Remove Swing Away Leg Rest

Question 8

T/F: It is okay to ask the patient if they understand?

Answer 8

False too simple, explain details of the activity and how the patient can participate

• We are going to..
• I will help you…
• I would like you to…
• I will say “1,2,3 turn”

Question 9

How do you prepare the patient?

Answer 9

1. Explain details of activity and how the patient can participate.
2. Demonstrate as appropriate.
3. Have patient describe and practice components of transfer.
4. Ensure patient is properly dressed or draped with proper shoes or slippers
5. Check for tubes lines, and monitors etc.

Question 10

Types of Assistance (4)

Answer 10

V.C.’s (verbal cueing or manual)
Balance Control (holding onto gate belt)
Lifting (their body weight)
Supporting (patient)

Question 11

What is an independent assistance?

Answer 11

No longer needed. Predictor for discharge.

Question 12

What is a SBA/Close Guard assistance?

Answer 12

Stand by Assist or close guard, not willing to turn back on patient, still not confident they won’t need you assistance.

Question 13

What is Contact Guard assistance?

Answer 13

Actually have hand on patient

Question 14

What is a Min A?

Answer 14

Patient is able to do 75% of the transfer or mobility activity by themselves.

Question 15

What is a Mod A?

Answer 15

Patient is able to do 50-75% of the transfer or mobility activity by themselves.

Question 16

What is a Max A?

Answer 16

Patient is able to do 25-50% of the transfer or mobility activity by themselves.

Question 17

What is a Total Assist/Dependent?

Answer 17

Patient is able to do 0% of the transfer or mobility activity by themselves. You are doing a max lift or total assist?

Question 18

How is a Max Assist recorded?

Answer 18

1,2,3 depending on how many people assist with transfer.

Question 19

What is the Goal for the activity?

Answer 19

Achieve maximum level of patient independence in safe way.

Question 20

When should you use a Hoyer lift?

Answer 20

If you are unsure you can perform a lift in a safe matter. Be careful of spreading germs on sling.

Question 21

Proper body mechancis

Answer 21

Bend at hip and not back.
Keep both feet on the floor.
Don't twist and rotate body.
Have gait belt secure to doesn't slip.
Remove wheelchair parts.

Question 22

.

Answer 22

Patient should be wearing shoes or leather slippers.
Do not leave patient unattended.
Assess for any changes in patient status from previous visit that may impact care.

Question 23

Total Hip Arthroplasty Precautions

Answer 23

Avoid: 
Hip adduction, crossing midline
Hip Rotation (IR>ER)
>60/90 deg hip flexion (varies based on surgery
Lying on Hip
Pulling on LE

Question 24

Promote THA?

Answer 24

Do keep hip abducted during movement or in side lying

Do use a recliner for sitting (greater than 90 deg flexion)

Question 25

THA precautions are similar to (2)

Answer 25

THA same for dislocation or hip fracture

Question 26

LBP/Lumbar Trauma, Post-Operative Spine Surgery Precautions

Answer 26

Avoid:
Lumbar Rotation
Trunk Lateral Flexion
Trunk Flexion
Excessive Trunk Flexion

Question 27

Promote

Answer 27

Do logroll (pelvis and shoulder move as one unit)
Do keep knees flexed for comfort in supine and sidelying
Adhere to post-operative guidlines

Question 28

Spinal Cord Injury Precautions

Answer 28

Avoid:
With fixation devices:
-Rotation
-Distraction (don’t pull on LE’s)

Question 29

Spinal Cord Injury Promote

Answer 29

Promote:
Awareness of fixator device
Awareness of osteoporosis (especially LEs and Vertebrae)
Use protective positioning/restraints with side-lying, sitting without back support
Watch out for orthostatic hypotension and autonomic hyperreflexia
Do log roll