Assistive Devices (LVAD) (Nursing)

00:01 Hi, I'm Joanna and we're going to review assistive devices. There are a large variety of assistive devices. They allow patients to ambulate and complete daily activities of life safely. Some examples of assistive devices include crutches, wheelchairs, canes, walkers, shower chairs, transfer devices, and toilet chairs.

00:27 Here are some key terms that are really important for you to know, learn, and understand. Practice them, write them down, and pretend as if you're the nurse talking to the patient, so you get comfortable using them. Listen for these key terms throughout this lesson, write the definitions, practice using the words in sentences, and visualize using the words as a nurse. Now, we'll talk about who needs assistive devices. Patients with muscle weakness, temporarily after injury or a surgical procedure, a patient with inadequate balance or gait, or someone with ineffective coordination. The nursing process is always important. Remember your assessment, your diagnosis, and your planning.

01:09 Don't forget to implement and then evaluate all the things that you've done.

01:16 Patients who spend a large amount of time lying or sitting may be dizzy or weak when standing.

01:21 Never use assistive devices or transfer devices that you have not been trained to use. And your safety is as important as the patient's safety. Use proper body mechanics when transferring and assisting any patient. Crutches are used when a patient cannot bear full weight on a limb. Crutches should be three fingerbreadths of space between the pad and the axilla. It's easy enough to measure by taking your three fingers and placing them under the patient's arm. The patient must bear weight on the hands and not the armpits. The affected leg or foot should always be slightly in front and not behind as some patients frequently do.

02:01 With completing patient education, don't forget to teach them how to go up and downstairs safely. When going up the stairs, the patient should place the unaffected leg on the step, then bring the crutches up, then the affected leg last. When teaching a patient to go down the stairs, remember it's practically the exact opposite of going up the stairs.

02:23 The patient should place the crutches in the affected leg on the stair below, and then bring down the unaffected leg. There're variety of different gaits that we use with the patient on crutches. The doctor typically prescribes this and it's based upon how much weight the patient can bear. A two-point gait is for patients who are able to bear partial weight. The patient moves one foot and the opposite crutch forward at the same time. An easy way to remember this is to always think the opposite. A three-point gait is for patients who are unable to bear weight on the affected leg or foot at all. The patient will move both crutches and the affected leg forward at the same time then bring the back leg forward. A four-point gait is for patients who are able to bear weight on the affected limb. The patient moves each leg in the crutch separately, one at a time.

03:19 Move the first crutch forward, then the opposite leg of that crutch. Bring the remaining crutch forward, followed by the remaining leg, one at a time, starting with the crutch always. Now, we will review wheelchairs. Be sure to explain the procedure and the plan to the patient prior to beginning. Transfer the patient from the bed to the wheelchair which may require assistive devices or additional personnel. Especially initially if you're unsure of the patient's ability to bear weight, always have an extra pair of hands to help you.

03:52 Be sure to lock the wheelchair prior to the transfer and position the patient properly in the chair and avoid any pressure on bony prominences. Here are some really important takeaways. Patient education and safety.

04:06 Many of your questions will be centered around this. It's most important when you're studying this content.

04:12 Practice teaching a patient how to use assistive devices, and know what's improper use, such as bending their affected leg backwards, behind the crutch. When in doubt, always assess, diagnose, plan, and then implement. Always assess before any action. If two answers feel correct, choose the best answer, and opposites attract.

04:35 If two answers are complete opposites, usually the correct answer is in one of those.