Mobility

Question 1

Paraplegia

Answer 1

paralysis in the lower half of the body

Question 2

Quadriplegia

Answer 2

paralysis involving all 4 limbs

Question 3

Hemiplegia

Answer 3

paralysis on one side of the body

Question 4

Ataxia

Answer 4

clumsy, uncontrolled movements (this occurs when attempting to move)

Question 5

Spastic

Answer 5

uncontrolled contractions of skeletal muscles. Movement may occur without any attempt or desire

Question 6

Good Body Mechanics

Answer 6

1. use larger muscles in your legs to lift instead of smaller back muscles that are injured more easily
2. turn or pivot your feet instead of twisting
3. have a wide base of support (feet shoulder width apart)
4. push, pull or slide objects, rather than lifting them
   bend your knees and hips, not your back

Question 7

Supine

Answer 7

flat on back

Question 8

Sims

Answer 8

on left side, leaning toward the front with right knee bent higher than left knee.

Question 9

Fowlers

Answer 9

head of bed elevated (low, medium or high)

Question 10

Repositioning

Answer 10

1. reposition q2h at a minimum to assist in preventing complications of bedrest
2. following a hip fracture, trochanter rolls and hip abduction wedges are used provide proper positioning to prevent external rotation of the hip
3. wedges or pillows may be used for positioning in side-lying postures
4. bed cradles may be used to keep the weight of blankets off of the feet
5. When repositioning a person with a spinal fracture, log rolling is needed. The persons body should remain in alignment throughout, while they are turned as one unit with one motion. Generally a minimum of 3 people is required
6. if a person has traction, this is not to be removed while repositioning
7. use a lift or transfer sheet to prevent friction or shearing, increase comfort for the client and minimize the risk of injury to the worker

Question 11

Bedrest complications (5)

Answer 11

1. pneumonia
2. blood clots (thrombi), especially in the legs
3. muscle atrophy: decrease in size or wasting of skeletal muscle tissue
4. contractures: shortening of muscles resulting in permanent deformity and disability
5. decubitus ulcers, aka bed sores or pressure sores

Question 12

Preventing complications of bed rest (3)

Answer 12

reposition at least q2h
encourage adequate nutrition and fluids
exercise while in bed: ROM

Question 13

Range of Motion (ROM)

Answer 13

1. may be done actively (by the client), passively (by the worker) or a combination of both
2. only complete the ROM on joints you are instructed to. if done incorrectly, injury may result
3. move the limb in a slow and controlled manner while supporting the limb
4. use good body mechanics
5. do not move past the point of pain
6. know your terminology for movements: flexion (bending), extension (straightening out), abduction (moving away from the midline of the body) and adduction (moving toward the midline of the body)

Question 14

Flexion

Answer 14

Bending

Question 15

Extension

Answer 15

Straightening

Question 16

Abduction

Answer 16

Away from midline

Question 17

Adduction

Answer 17

Towards midline

Question 18

Transfer

Answer 18

assisting a person who is at least partially weight bearing to move from one place to another. Always follow the direction on the care plan and/or logo for the type of transfer and number of people required. A PSW may always provide more support than the care plan or logo indicates, but never less. Remember, when transferring a person with weakness on one side of their body, always lead with the unaffected side.

Question 19

Lift

Answer 19

moving a person who is non-weight bearing from one place to another. A mechanical lift is required for this as there is a no lift policy in healthcare (a healthcare worker cannot support all of another persons body weight using your muscles). There must always be 2 trained people to use a mechanical lift.

Question 20

Mobility Aid

Answer 20

1. Canes, walkers and crutches are common. Be certain to check the equipment for safety and ensure the client is wearing appropriate footwear prior to using these
2. Braces: there are many different types of braces to support limbs, joints, or even the trunk of the body during movement. Follow the care plan and be certain you know how and when to these must be used. Always observe for pressure points or skin breakdown under the brace when applying or removing and be certain to report any changes.
3. Transfer belt: may be used to provide grip to assist a person to transfer or to walk down the hall if the person is weak or unsteady on their feet
   Turning disc: assists with turning a person to direct them to the spot they are transferring to if they are unable to pivot their feet safely but can support their own weight

Question 21

Cane/walker/crutches

Answer 21

Be certain to check the equipment for safety and ensure the client is wearing appropriate footwear prior to using these

Question 22

Braces

Answer 22

there are many different types of braces to support limbs, joints, or even the trunk of the body during movement. Follow the care plan and be certain you know how and when to these must be used. Always observe for pressure points or skin breakdown under the brace when applying or removing and be certain to report any changes.

Question 23

Transfer Belt

Answer 23

may be used to provide grip to assist a person to transfer or to walk down the hall if the person is weak or unsteady on their feet
Turning disc: assists with turning a person to direct them to the spot they are transferring to if they are unable to pivot their feet safely but can support their own weight

Question 24

Preventing falls

Answer 24

1. reduce clutter
2. improve lighting and ensure glasses are clean
3. encourage the use of mobility aids or hand rails
4. if the person has been on prolonged bedrest or has orthostatic hypotension, move slowly. Begin with sitting up. It can be beneficial to sit and dangle the legs over the side of the bed to prevent dizziness and falls
   provide close supervision and frequent checks
   use bed alarms and chair alarms to alert you if they are getting up
5. respond promptly to call bells
6. anticipate the need to get out of bed (for example, when do they generally use the washroom?)

Question 25

If someone is falling

Answer 25

If a person is beginning to fall and you are already right there, you may try to ease the person to the floor. However, never try to break someone's fall, as you are risking greater injury to both yourself and the client.

Question 26

If someone has fallen (LTC)

Answer 26

If a person has fallen in a LTCF, encourage the person to stay where they are and call for the nurse. Once the nurse has assessed you may use a mechanical lift to assist them off of the floor. You can NEVER help them up without a mechanical lift.

Question 27

if someone has fallen (Home)

Answer 27

If a person has fallen in their own home, assess for injury to the level of your knowledge, checking for any pain, redness, bumps or bruises. Do not move the person. If they can get themselves up, that is their choice, but if you feel it is not safe for them to do so, encourage them to wait for further assessment. Know the policy of where you are working, but in most cases it is a 911 call for a lift assist.