Crutches, Canes, and Walkers Nursing NCLEX Assistive Devices Review

Use a gait belt and stand on the patient's weak side. Instruct the patient to look straight ahead, not down at their feet. The back tips of the walker should align with the middle of their foot. Lift and move the walker forward, ensuring all four points are on the ground. Then, move the weak leg, put weight on the handgrips, and move the strong leg.

To sit, back up to the chair holding the handgrips until the legs touch. Extend the weak leg, place hands on the chair's armrests, and use the strong leg to sit down. To stand, ensure the walker is in front, lean forward, hands on armrests, extend the weak leg, push up from armrests, and place hands on the walker handgrips.

Walker legs must be adjusted. When standing with the walker, there should be a 15-30 degree bend in the elbows. The wrist crease should line up with the handgrips when arms are at the sides.

To sit, back up to the chair feeling it with the back of the legs, rest the cane, place both hands on armrests, keep the weak leg extended, and bend the strong leg to sit. To stand, place the cane on the strong side, lean forward, keep the weak leg extended, push down on the cane's hand grip and armrest, and put weight on the strong leg to stand.

Crutches must be adjusted to the patient's height. There should be a 2-3 finger width (1-1.5 inches) gap between the crutch rest pad and the armpit to prevent nerve damage. Weight should be on the hand grips, which should align with the hip line, resulting in a 30-degree elbow bend.

Before ambulating, ensure a gait belt is worn and the patient starts in a tripod position (crutches 6 inches diagonally from feet). Point gaits (2-point, 3-point, 4-point) involve counting how many crutches and feet are on the ground at a time. Swing gaits (swing-to and swing-through) involve moving crutches forward and then swinging legs to or past the crutch placement.

To go up stairs: 'good up'. The good (strong) leg goes first, followed by crutches and the bad (injured) leg. To go down stairs: 'bad down'. Crutches go down first for stability, followed by the bad leg, then the good leg.

To sit, back up to the chair until the non-injured leg touches, move both crutches to the injured side for support, grip handgrips, and sit down keeping the injured leg extended. To stand, place crutches on the injured side, keep the injured leg extended, and push up using handgrips and the non-injured leg.

The top of the cane should be even with the greater trochanter or the wrist crease closest to the hand. When holding the cane, the elbow should be flexed at a 15-30 degree angle.

Always wear a gait belt for safety, and the nurse should stand on the patient's weak side. The cane should be held on the strong side of the body, with its tip about four inches from the foot. Move the cane and the weak leg forward together, then move the strong leg forward.

The rule 'good up, bad down' applies. Going up stairs: hold the cane on the strong side, move the good leg up, put weight on the cane, then move the cane and bad leg up. Going down stairs: hold the cane on the good side, move the cane and bad leg down, then move the good leg down.