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Assisting a Client to Ambulate

Unit 8 Lesson 4

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Describe how the nurse’s aide safely ambulates clients
Identify devices used to assist the client in ambulation
Describe actions taken by the nurse’s aide when a client starts to fall while standing or ambulating

Student Learning Outcomes

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Ambulation

Act of walking
Benefits

Promotes bone health through weight-bearing activity
Enhances joint mobility
Improves circulation and overall well-being

Assessment

Conducted by a physical therapist
Determines need for assistance or devices

Sandquist-Reuter, 2023

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Preparations for Safe Ambulation

Footwear

Ensure client wears non skid footwear to prevent slips

Pre-ambulation Steps

Allow client to "dangle" at the bed's edge to prevent dizziness

Positioning

Nurse’s aide stands to the side and slightly behind the client for support
Use of gait belt for added security

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Assistive Devices for Ambulation

Selection

Based on physical therapist’s recommendations

Cane

Position on the stronger side

Sequence

Step with stronger leg, then use cane and weaker leg

Sandquist-Reuter, 2023

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Assistive Devices for Ambulation continued…

Walkers

Standard Walker

Maximum support
Slower pace

Two-Wheeled Walker (2WW)

Moderate support with some mobility

Four-Wheeled Walker (4WW)

For clients with better balance

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

Which of the following is the correct procedure for a nurse's aide assisting a client using a walker?

A. Encourage the client to shuffle their feet while using the walker for support.

B. Instruct the client to stand up straight and look forward while using the walker.

C. Position the walker on the client's weaker side.

D. Allow the client to use the walker without any footwear.

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Role of the Nurse’s Aide in Ambulation

Positioning and Support

Stand on the weaker side, hand under the gait belt with fingers facing upward
Use bicep strength for support

Stronger than forearm

Posture and Movement

Encourage upright posture and forward gaze
Promote purposeful steps
Discourage shuffling

Sandquist-Reuter, 2023

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Critical Thinking Question

A client with a weaker left leg is about to ambulate using a cane. Describe the steps the nurse's aide would take to safely assist the client.

What should the nurse's aide be mindful of during this process?

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Assisting During Ambulation

Supervision

Second staff member may follow with a wheelchair for safety

Emergency Protocols

Be ready to assist if client shows signs of weakness or dizziness

Sandquist-Reuter, 2023

Contact info: info@nursesinternational.org

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Critical Thinking Question

While assisting a client with ambulation, the nurse's aide notices they seem weak and unsteady. What should the nurse's aide's immediate action be?

A. Quickly sit the client down on the nearest available chair.

B. Call for another staff member to bring a wheelchair for support.

C. Encourage the client to continue walking to build strength.

D. Tighten the grip on the gait belt and instruct the client to stop and rest.

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Responding to Falls During Ambulation

Safety First

Do not try to catch the client
Protect your back

Controlled Descent

Move behind client
Support at waist/hip or gait belt
Bend knee, slide client down leg, protecting their head

Sandquist-Reuter, 2023

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Responding to Falls During Ambulation continued…

Post-Fall Procedure

Notify nurse immediately for assessment
Use mechanical lift to transfer client after assessment
Complete incident report and provide a statement

Sandquist-Reuter, 2023

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Lowering a Client Who is Falling to the Floor

Sandquist-Reuter, 2023

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Critical Thinking Question

During ambulation, a client starts to lose balance and begins to fall. Describe how the nurse's aide would safely assist them to the ground.

What steps should the nurse's aide take immediately after the fall?

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References

Sandquist-Reuter, M. (2023). Nursing Assistant. WisTech Open. https://wtcs.pressbooks.pub/nurseassist/

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