Assisting with Ambulation

Teresa V. Hurley, MSN, RN

Dangling a Client
 Prevent injury
 Seated position at side of bed with feet
touching the floor
 Gaze looking forward
 What is orthostatic hypotension?
Ambulation
 Stand erect
 Gaze forward
 Heel to toe
 Opposite arm swing to opposite leg
Nursing Assistance
 One Nurse Assist

 Two Nurse Assist

Special Consideration
 Client has one-sided weakness or paralysis
 Nurse stands on the weaker or affected side
 With arm around waist to stabilize the client
Preventing Injury: Falls
 Client begins to fall or feels faint

 What are you going to do?

Nurse Guides to Floor
 Move hip forward closest to client with a
wide base of support and have client slide
down your leg into a sitting or lying
position
Walking Assistive Devices
 Canes
 Walkers
 Braces
 Walking belts
Canes
 Single-ended curve ended ideal for use with
stairs
 Single-ended straight ended used when
balance is intact and hand weakness exists
 Multi-prong used when there is balance
problems because it has a wide base of
support
Canes
 Rubber tipped
 Sizing: bottom 4 inches to side of foot
 Sizing: top reaches hip joint
 Held with stronger side with elbow bent at 30
degree angle
 Weight evenly distributed
 Advance weaker leg and cane simultaneously
 Swing stronger leg
 Avoid leaning forward
Walkers
 Client picks up walker and advances as
steps ahead
 Impaired side advances first ahead after
picks up walker
Braces
 Support joints and muscles that can not
support body weight
Crutches
 Reliance on strength of arms and shoulders
 Limit or eliminate weight bearing
 Forearm Support Crutches used for
permanent limitations
 Axillary Crutches used for short or long
term
Axillary Crutches
 Body weight carried on arms and hands and not
axilla
 2 Point Gait and 4 Point Gait used for partial
weight bearing
 3 Point Gait non-weight bearing
 Swing to and Swing through for weight bearing
 Upstairs lead with unaffected and going down
stairs lead with effected
Crutches
 Measure by lying flat in bed with shoes
used for walking
 Measure from anterior fold of axilla to the heel
and add 1 inch = 2.5 cm
 Standing position: crutch pad should be three
finger breaths from anterior fold of axilla