Crutches, Canes, and Walkers Nursing NCLEX Assistive Devices Review

Summary

This video covers the proper use of assistive devices like crutches, canes, and walkers, essential for nursing school exams. It explains how to ensure correct fit, types of walking gaits (two, three, and four-point), and how to use these devices for navigating stairs, sitting, and standing. Viewers learn safety tips, including the importance of using a gait belt, how to assist patients, and key principles such as 'good leg up, bad leg down' when climbing stairs. The video also provides tips on ensuring proper body positioning and technique for effective ambulation.

Takeaways

• 😀 Proper crutch fit is crucial: There should be a 1-1.5 inch gap between the crutch pad and armpit to prevent nerve damage.
• 🦽 Hand grips on crutches should align with the top of the hip line, and elbows should bend at a 30-degree angle.
• 💡 There are three main crutch gaits: 2-point, 3-point, and 4-point. Each involves specific movements of the crutches and feet based on the patient’s injury.
• 📏 Crutch users should use the tripod position as a starting point, with crutches placed 6 inches diagonally from the feet.
• ⬆️ When going upstairs with crutches, lead with the good leg first. For downstairs, lead with the bad leg and crutches for stability.
• 🪑 When sitting or standing with crutches, the crutches should always be placed on the injured side to support the patient.
• 🦯 A cane should be adjusted so the top aligns with the greater trochanter or wrist crease, ensuring proper elbow flexion at a 15-30 degree angle.
• 🚶‍♀️ When walking with a cane, the cane should be held on the strong side, and the patient should move the cane and weak leg forward together.
• 🔼 For stairs with a cane, the strong leg leads up, and the weak leg with the cane leads down following the 'good up, bad down' rule.
• 🦼 Walker fit is key: elbows should bend 15-30 degrees, and wrists should align with handgrips when arms are at the side. The weak leg moves first, followed by the strong leg during ambulation.

Q & A

What is the proper way to fit crutches for a patient?

To fit crutches properly, ensure there is a 1-1.5 inch (2-3 fingers' width) gap between the crutch pad and the armpit to avoid nerve damage. The hand grips should be adjusted so that the elbows are bent at about 30 degrees and the grips align with the top of the patient's hip line.

What are the different types of crutch gaits?

There are three main types of crutch gaits: 2-point, 3-point, and 4-point gaits. In the 2-point gait, the patient moves one crutch and the opposite foot together. In the 3-point gait, both crutches and the injured leg move together, followed by the non-injured leg. The 4-point gait involves moving each crutch and each foot separately.

How should a patient go up and down stairs using crutches?

When going up stairs, the patient should step up with the good leg first, followed by the crutches and the bad leg. When going down stairs, the crutches go down first, followed by the bad leg, and finally the good leg.

What is the difference between a swing-to gait and a swing-through gait when using crutches?

In a swing-to gait, the patient moves both crutches forward and then swings both legs to the placement of the crutches. In a swing-through gait, the patient moves both crutches forward and swings both legs past the placement of the crutches.

How do you ensure a cane fits a patient properly?

A cane fits properly when the top of the cane aligns with the patient's greater trochanter or the wrist crease when standing upright. Additionally, the patient’s elbow should be flexed at a 15-30 degree angle when holding the cane.

On which side of the body should a patient hold a cane?

The cane should be held on the strong side of the body to provide support for the weaker or injured side.

How does a patient walk using a cane?

To walk with a cane, the patient should move the cane and the weak leg forward together, followed by moving the strong leg forward. This provides stability during ambulation.

What is the correct method for going up and down stairs with a cane?

When going up stairs with a cane, the patient should step up with the good leg first, followed by the cane and the weak leg. When going down, the cane and the weak leg go down first, followed by the good leg.

How should a walker be adjusted to fit a patient?

To ensure a proper fit, the patient’s elbow should be flexed at a 15-30 degree angle when holding the walker grips, and their wrist crease should align with the hand grips when their arms are relaxed at their sides.

What is the correct way for a patient to walk with a walker?

To walk with a walker, the patient should first lift and move the walker forward so all four points are on the ground. Next, they should move the weak leg forward, followed by the strong leg, while bearing weight on the hand grips for stability.