Chapter 3. Safe Patient Handling, Positioning, and Transfers Show
Immobility in hospitalized patients is known to cause functional decline and complications affecting the respiratory, cardiovascular, gastrointestinal, integumentary, musculoskeletal, and renal systems (Kalisch, Lee, & Dabney, 2013). For surgical patients, early ambulation is the most significant factor in preventing complications (Sanguinetti, Wild, & Fain, 2014). Lack of mobility and ambulation can be especially devastating to the older adult when the aging process causes a more rapid decline in function (Graf, 2006). Ambulation provides not only improved physical function, but also improved emotional and social well-being (Kalisch et al., 2013). Prior to assisting a patient to ambulate, it is important to perform a patient risk assessment to determine how much assistance will be required. An assessment can evaluate a patient’s muscle strength, activity tolerance, and ability to move, as well as the need to use assistive devices or find additional help. The amount of assistance will depend on the patient’s condition, length of stay and procedure, and any previous mobility restrictions. Assisting Patient to the Sitting PositionPatients who have been immobile for a long period of time may experience vertigo, a sensation of dizziness, and orthostatic hypotension, a form of low blood pressure that occurs when changing position from lying down to sitting, making the patient feel dizzy, faint, or lightheaded (Potter, Perry, Ross-Kerr, & Wood, 2010). For this reason, always begin the ambulation process by sitting the patient on the side of the bed for a few minutes with legs dangling. Checklist 27 outlines the steps to positioning the patient on the side of a bed prior to ambulation (Perry, et al., 2014). Checklist 27: Assisting a Patient to a Sitting Position
Video 3.2Ambulating a PatientAmbulation is defined as moving a patient from one place to another (Potter et al., 2010). Once a patient is assessed as safe to ambulate, determine if assistance from additional health care providers or assistive devices is required. Checklist 28 reviews the steps to ambulating a patient with and without a gait belt. Checklist 28: Ambulating a Patient
Video 3.3Video 3.4Watch the video How to Ambulate with a Cane by Kim Morris of Thompson Rivers University. Video 3.5Watch a video How to Ambulate With Crutches by Kim Morris, Thompson Rivers University.
Which nursing intervention is appropriate for preventing atelectasis in the postoperative patient *?Incentive spirometry has been a mainstay of nursing postoperative atelectasis prevention.
What is the maximum time the nurse apply suction when performing endotracheal?The suction time should not exceed 15 seconds, and the negative pressure must not exceed 100mmHg. Hyperoxygenation should not be used routinely and is only indicated when the baby has a clinically significant reduction in peripheral oxygen saturation during suctioning.
Which complication occurs in a patient with noninvasive ventilation?NIV can also increase right ventricular afterload or function to reduce left ventricular afterload. Potential detrimental physiologic effects of NIV are ventilator-induced lung injury, auto-PEEP development, and discomfort/muscle overload from poor patient–ventilator interactions.
Which laboratory test would the nurse monitor to determine a patient's ability to oxygenate select all that apply?A patient's oxygenation status is routinely assessed using pulse oximetry, referred to as SpO2 . SpO2 is an estimated oxygenation level based on the saturation of hemoglobin measured by a pulse oximeter.
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