A nurse is teaching a client about crutch walking using the three-point gait. Which of the following statements by the nurse should be included in the teaching?

"Support your body weight on the underarm crutch pads."

"Look down at your feet before moving the crutches."

"Place one crutch forward with the opposite foot and then place the second crutch forward followed by the second foot."

"Move both crutches forward while standing on the unaffected leg, then lift and swing your body past the crutches."

Answer and Explanation

The Correct Answer is D

A.   Crutches should not be used to support body weight under the arms, as this can cause nerve damage or discomfort. Instead, weight should be supported on the hands and arms, with the crutches positioned to support the client’s weight. Proper use involves placing the crutches slightly in front of the feet, with weight supported on the hands, not the underarms.
B.   While it's important to be aware of your surroundings, looking down at your feet can be counterproductive as it may affect balance and coordination. The client should maintain an upright posture and look ahead to ensure proper gait and balance while moving. This helps in coordinating the movement of crutches and feet more effectively.
C.   In a four-point gait, each crutch and foot move alternately, which is different from the three-point gait. The three-point gait involves moving both crutches and the affected leg forward simultaneously, followed by the unaffected leg.
D.   In the three-point gait, the client moves both crutches forward at the same time while keeping the affected leg off the ground or in a non-weight-bearing position. Then, the client swings the unaffected leg forward to step past the crutches. This method ensures that weight is only placed on the unaffected leg while moving.

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Correct Answer is D

Explanation

A. Keeping spare crutch tips handy is a good practice. Crutch tips can wear out over time and need to be replaced to maintain stability and safety. Having spare tips ensures that the client can replace them as needed and avoid potential accidents or falls.
B. Bearing the weight of the body on the hands is an incorrect usage of crutches. The proper technique involves placing weight on the hands and forearms rather than the armpits. The weight should not be supported by the axillae (armpits) to prevent nerve damage and discomfort.
C. Inspecting crutches daily for signs of wear is a recommended practice. Regular inspection helps identify any issues with the crutches, such as worn tips or loose fittings, which could compromise their effectiveness and safety.
D. Using crutches from another person can be problematic. Crutches should be properly fitted to the user to ensure safety and effectiveness. Using crutches that are not adjusted to fit the client's height and needs can lead to improper use, discomfort, and increased risk of injury.

A. Provide assistance to bathroom. B. Insert a straight catheter. C. Perform a bladder scan. D. Increase fluids.

Correct Answer is C

Explanation

A. The client may have difficulty voiding despite being taken to the bathroom, especially if there is an underlying issue such as urinary retention or an obstruction. Therefore, this step is usually taken after assessing the situation further.
B. Inserting a straight catheter is an invasive procedure that should not be the initial action. It is typically done after other non-invasive measures have been taken to evaluate the reason for the lack of voiding. Straight catheterization can be considered if other methods do not resolve the issue or if there is a clear indication of urinary retention that needs immediate intervention.
C. Performing a bladder scan is the appropriate first step. A bladder scan, or portable ultrasound, helps assess the amount of urine in the bladder and determines if the client is retaining urine. This non- invasive procedure can provide valuable information about the presence of urinary retention, which guides further intervention.
D. Increasing fluid intake might be appropriate if the client is dehydrated or has not been drinking enough fluids. However, this step is not the first action to take if the client has not voided for 8 hours. The priority is to determine if there is a physiological issue, such as urinary retention, before increasing fluids.

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A nurse is teaching a client about crutch walking using the three-point gait. Which of the following statements by the nurse should be included in the teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is C

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