Nursing Chapter 33: Logrolling Technique

Questions and Answers

Which assistive technique should the nurse prioritize in the plan of care for a bedbound client?

Trapeze bar (correct)

Trochanter rolls

Pull sheets

Log rolling

What intervention should the nurse implement to promote ventilation in a client with chronic obstructive pulmonary disease?

Instruct the client to place arms on the side rails

Place a small pillow under each arm (correct)

Place a trochanter roll under the arms

Elevate the head of the bed

Which assessment findings would cause the nurse to choose a different assistive device instead of a power stand-assist machine?

The client makes no attempt to help with transfers. (correct)

The client is oriented to self, but not time or place. (correct)

What is the correct documentation for a client with impaired muscle coordination?

Ataxia Signup and view all the answers

What knowledge about the bones should the nurse apply when working with a client who has a fractured wrist?

Short bones contribute to movement. Signup and view all the answers

What finding should the nurse document as a normal age-related change in an older adult client?

Decrease in flexibility Signup and view all the answers

What action should the nurse instruct a client with a history of lung disease before beginning an exercise program?

Obtain a pre-exercise medical examination for clearance Signup and view all the answers

What are hand rolls used for in client care?

To preserve the client's functional ability to grasp and pick up objects. Signup and view all the answers

Which action by the UAP would cause the nurse to intervene when assisting an inactive client with positioning?

Lowering the height of the bed prior to moving the client Signup and view all the answers

What is one of the most common injuries associated with exercise in a healthy person?

Muscle injury Signup and view all the answers

Which assessment priority is needed for an adolescent client?

Scoliosis Signup and view all the answers

What teaching point would be appropriate for promoting exercise in an older adult client?

Encourage the client to warm up before beginning exercises and to cool down after exercising. Signup and view all the answers

Which statement correctly describes good posture when lying down?

Picture yourself with good posture standing; that is how good lying posture works. Signup and view all the answers

In which position should the nurse place a client to prevent sliding toward the foot of the bed?

Slight Trendelenburg Signup and view all the answers

Where should the nurse position the stretcher when transferring a client from a bed?

Alongside the bed at the same height Signup and view all the answers

When logrolling a client, the nurse should use supportive devices in turning the client in order to:

Maintain the natural alignment of the client's body. Signup and view all the answers

When turning a client in bed, what muscle groups would the nurse use to pull the client to the opposite side of the bed?

Leg Signup and view all the answers

After successfully turning the client to the side, where would the nurse place an additional pillow?

Supporting the client's back Signup and view all the answers

What is a recommended guideline when assisting a client from the bed into a wheelchair?

Raise the head of the bed to a sitting position. Signup and view all the answers

For what adverse condition is the nurse assessing the client when they show signs of dizziness upon standing?

Orthostatic hypotension Signup and view all the answers

For which condition would the nurse consider a bedridden client to be at risk?

Predisposition to renal calculi Signup and view all the answers

Into which position will the nurse place the client who reports shortness of breath while lying prone?

Fowler's Signup and view all the answers

In an assessment for proper body alignment of a standing client, which finding is normal?

The weight of the body is distributed on the soles and heels. Signup and view all the answers

What should the nurse do upon entering a hospital room and observing a UAP making the bed while a client is in therapy?

Inform the UAP the linens should not be placed on the floor for any reason Signup and view all the answers

How should the nurse best prevent or minimize damage from a client who begins to fall?

The nurse should gently slide the client down his or her body to the floor. Signup and view all the answers

In what position would the nurse place the client to begin the procedure of turning in bed?

Lying flat Signup and view all the answers

What is the best explanation for why a client does not bump into a bedside table while ambulating in the room?

The client is aware of spatial relationships to avoid the table. Signup and view all the answers

Which nursing action is appropriate when transferring a client from a bed to a wheelchair?

The nurse uses assistive devices when lifting more than 35 lb (16 kg) of client weight. Signup and view all the answers

Which client would be a likely candidate for using a gait belt?

A client who has leg strength and can cooperate with the movement. Signup and view all the answers

What can be expected developmentally from a 2-year-old child over the next few years?

The client will continue to grow rapidly and will refine both gross and fine motor skills. Signup and view all the answers

Which activities would help to prevent falls for a 90-year-old client with a hemiplegic gait?

Removing clutter from the floor. Signup and view all the answers

What is the priority nursing diagnosis for a client with incontinence left in a supine position for more than a week?

Risk for impaired skin integrity. Signup and view all the answers

What risk factor associated with flying should the nurse emphasize for a client who flies often?

Thrombus formation. Signup and view all the answers

Which method is most appropriate to assist a 76-year-old client with an unsteady gait during transfer?

Transfer belt. Signup and view all the answers

In what position will the nurse place the client to facilitate a rectal examination?

Sims'. Signup and view all the answers

A nurse is supervising a client who wants to transfer from the bed to a stretcher without assistance. What is the best response?

You are free to move onto the stretcher without assistance, but I will supervise for your safety. Signup and view all the answers

How should the nurse stand when helping the client sit up on the side of the bed during a transfer?

Near the client's hip, with legs shoulder width apart and one foot near the head of the bed. Signup and view all the answers

What position should the nurse take when assisting a client from the bed into a wheelchair?

Near the client's hip, with legs shoulder width apart and one foot near the head of the bed. Signup and view all the answers

What is the primary purpose for using proper body mechanics?

Acts to prevent injury to the client and/or nurse Signup and view all the answers

Which client would the nurse be most concerned about regarding physical activity?

The middle-aged computer programmer Signup and view all the answers

What motions should the nurse make to move an object using proper body mechanics?

The nurse uses the internal girdle and a long midriff to stabilize the pelvis and protect the abdominal viscera. Signup and view all the answers

Which guideline promotes safe use of a cane for a client with unilateral weakness?

When taking a step forward, the heel of the client's foot should be slightly beyond the tip of the cane. Signup and view all the answers

What should the nurse advise a client using crutches?

Your elbows will be slightly bent when you are using your crutches. Signup and view all the answers

What should a nurse do when a client reports dizziness during transfer from bed to wheelchair?

Firmly grasp the gait belt and gently lower the client into bed. Signup and view all the answers

Which action should the nurse take after turning a client on bed rest to the left side?

Pull the shoulder blade forward and out from under the client. Signup and view all the answers

Which developmental concern would the nurse have for a pediatric client?

The 24-month-old child who is unable to walk unassisted. Signup and view all the answers

What statement is most beneficial when assisting a client with dementia in getting dressed?

Put your arm in this sleeve. Signup and view all the answers

In which position should a client with hemorrhoids be placed for a rectal examination?

Sims' Signup and view all the answers

What information should a nurse provide to unlicensed assistive personnel (UAP) regarding meals for a partially blind older adult client?

Provide verbal cues regarding location of food on plate. Signup and view all the answers

What does a client who walks with knees slightly flexed and body leaning demonstrate?

Is demonstrating a common gait for the older adult. Signup and view all the answers

Which mobility aid is most appropriate for a client who has poor balance?

A cane with four prongs on the end (quad cane) Signup and view all the answers

Which activities can help prevent falls for a 90-year-old client with a hemiplegic gait? Select all that apply.

Placing nightlights in the bathroom and hallways Signup and view all the answers

What is the nursing response for the purpose of trochanter rolls?

To prevent your legs from rotating outward. Signup and view all the answers

How should graduated compression stockings be applied?

Have the client lie down and elevate feet for 15 minutes before applying stockings. Signup and view all the answers

Which strategies does the nurse use to maintain proper body mechanics? Select all that apply.

Plant feet firmly on the floor when supporting the client during dangling Signup and view all the answers

In which position(s) should a nurse place a client at high risk for aspiration?

Upright Signup and view all the answers

What intervention is appropriate for a 74-year-old client with kyphosis reporting cervical vertebra discomfort?

Placing a small towel under the neck. Signup and view all the answers

What type of exercise is represented by swimming laps and walking miles?

Isotonic Signup and view all the answers

Study Notes

Logrolling Technique

Logrolling is used for clients with back or spinal injuries to maintain spinal alignment and prevent injury.
Supporting devices help keep the natural alignment of the client's body and minimize discomfort.

Client Turning in Bed

When turning a client, the nurse utilizes leg muscles while keeping the gluteal and abdominal muscles engaged to avoid back strain.
An additional pillow should be placed under the client's back for support after turning them to the side.

Bed to Wheelchair Transfer

Raise the head of the bed to a sitting position before transferring the client to ensure comfort and safety.
Always lock the wheelchair brakes and position the chair close to the bed.

Assessing for Dizziness

Orthostatic hypotension is assessed by observing the client for dizziness or balance issues upon standing.
A blood pressure drop occurs when transitioning from a lying or sitting to a standing position.

Risks for Bedridden Clients

Bedridden clients are at increased risk for renal calculi due to urinary stasis and potential infections.
Immobility also affects respiratory function, metabolic rate, and increases overall health risks.

Positioning for Shortness of Breath

Fowler's position aids in alleviating dyspnea as it allows abdominal organs to drop away from the diaphragm.

Body Alignment in Standing Clients

Normal body alignment involves weight distribution on soles and heels, with the chest held moderately upward and abdominal muscles engaged.

Guiding UAP Behavior

Health care personnel should not place linens on the floor and should use proper body mechanics to avoid injury.

Fall Prevention Techniques

Strategies to prevent falls in elderly, at-risk clients include decluttering environments, installing nightlights, and relocating bedrooms to lower floors.

Nursing Diagnosis Prioritization

The top priority for a client with incontinence and prolonged supine positioning is risk for impaired skin integrity due to potential skin breakdown.

Risks of Prolonged Sitting

Long-term sitting during flights increases the risk for thrombus formation, necessitating discussion of stretching and mobility strategies.

Appropriate Transfer Aids

A transfer belt is optimal for clients with balance issues who can assist during transfers, supporting their weight safely.

Rectal Examination Position

Sims' position, semi-prone, is best for facilitating rectal examination, unlike other positions which limit visibility.

Supervision During Independent Transfers

Nurses should supervise clients who wish to transfer independently to ensure safety without intervention when clients can assist themselves.

Body Mechanics in Nursing

Proper body mechanics are critical to prevent injury to both clients and nurses during movement tasks.

Client Activity Concerns

Assessing physical activity levels should raise concern for sedentary clients such as middle-aged computer programmers, as their lifestyle may contribute to health issues.### Body Mechanics and Transfer Techniques
Nurses maintain proper body mechanics by balancing the head over shoulders, leaning forward, and engaging stomach muscles during object movement.
The internal girdle and a long midriff stabilize the pelvis and protect abdominal organs while lifting, pulling, or reaching.
When lifting, directly pick up objects instead of sliding or pushing to minimize energy expenditure against gravity.

Safe Cane Usage

For clients with unilateral weakness, hold the cane in the hand opposite the affected leg for better stability.
When stepping forward, the stronger leg should move ahead of the cane, with the heel beyond the cane's tip to promote balance.

Crutch Utilization

Crutches should be properly fitted so elbows remain slightly bent, with weight supported primarily by the hands rather than armpits.
Clients should rest if feeling fatigued while using crutches and should not rely on unlicensed personnel for supervision during ambulation.

Safe Patient Transfers

When a client reports dizziness during a transfer, the nurse should lower the client back into bed using a gait belt to prevent falls; standing may exacerbate dizziness.

Preventing Skin Integrity Issues

After turning a bedridden client, the nurse should reposition the shoulder blade forward to alleviate pressure on bony prominences and reduce the risk of skin breakdown.

Developmental Milestones in Children

A 24-month-old child who cannot walk unassisted raises concern, as walking is typically achieved by 15 months. Other developmental milestones are contextually appropriate for their respective ages.

Dressing Support for Dementia Clients

Short, clear instructions aid clients with dementia; for example, saying, "Put your arm in this sleeve," simplifies the dressing process compared to more complex commands.

Rectal Examination Position

The Sims' position is best for rectal examinations, allowing proper access compared to supine or prone positions.

Assisting Clients with Visual Impairments

During meals, position clients upright, provide verbal cues for food placement, cut food into small pieces, and ensure food temperature is safe to prevent aspiration.

Common Gait Patterns in Older Adults

Older adults may walk with slightly flexed knees and a leaning posture due to changes in balance and center of gravity, which is considered a normal adaptation.

Mobility Aids for Balance

A quad cane provides a stable base of support for clients with poor balance, while single-ended canes and crutches suit different mobility needs.

Fall Prevention Strategies

Key measures to prevent falls in elderly clients include clearing floor clutter, installing nightlights, and moving bedrooms downstairs for easier access.

Use of Trochanter Rolls

Trochanter rolls are utilized to prevent the outward rotation of legs during care, particularly for immobilized or post-surgery clients.

Compression Stocking Application

Elevate the client's legs for 15 minutes before applying graduated compression stockings to optimize effectiveness and comfort.

Maintaining Proper Body Mechanics

Effective lifting techniques include placing feet shoulder-width apart and bending at the knees rather than at the waist, avoiding strain on the back.

Positions to Prevent Aspiration

For clients at risk of aspiration, maintaining them in Fowler, Semi-Fowler, or upright positions enhances airway patency and respiratory function.

Kyphosis Comfort Measures

Placing a small towel under the neck can relieve pressure on cervical vertebrae for clients with kyphosis.

Types of Exercise Recognition

Isotonic exercise includes activities like swimming and walking, characterized by muscle shortening and active movement.

Enhancing Client Independence

A trapeze bar is effective for promoting independence and mobility in clients who are bedbound, unlike other nurse-initiated techniques.

Elevation for Ventilation

Placing small pillows under the arms can enhance ventilation for clients with respiratory conditions, compared to other non-effective methods.

Criteria for Assistive Device Usage

A power stand-assist machine requires the client to be cooperative, bear weight on at least one leg, and be able to follow instructions to be used safely.

Recognizing Muscle Coordination Issues

Ataxia indicates impaired muscle coordination; differentiate it from tremors, chorea, and athetosis, each having distinct movement characteristics.

Bone Classification Knowledge

The wrist is categorized as a short bone, contributing to movement, while other bone classifications (long, flat, irregular) serve various structural functions.### Flat Bones and Aging
Flat bones, located in the ribs and skull, play a role in structural contour and shape.
Typical age-related change includes a decrease in joint flexibility, important for assessment in older adults.
Pain in the lower back, stumbling gait, and unequal pupil size may indicate underlying pathology rather than normal aging.

Exercise Considerations for Older Adults

Clients with lung disease and arthritis should obtain a pre-exercise medical examination for safety before starting any exercise program.
Selecting enjoyable activities promotes adherence and success in exercise, emphasizing the importance of variety over single-exercise routines.

Roles of Positioning Devices

Hand rolls are designed to help maintain a client's ability to grasp and pick up objects, preventing contractures.
Trochanter rolls prevent leg rotation, while side rails support independent turning for weak clients.

Safe Client Handling Techniques

The height of the bed should be raised to elbow level of the caregiver before positioning a client to ensure proper ergonomics and safety.
Activities should encourage good body mechanics, preventing strain during client transfers.

Muscle injury is the most prevalent risk associated with exercise in healthy individuals, while major cardiac events are relatively uncommon in this demographic.
Exercise leads to enhanced muscle mass, tone, strength, and improved respiratory function, counteracting various health risks.

Adolescent Assessment Priorities

Scoliosis assessment is crucial during adolescence due to growth and development effects on posture.
Awareness of kyphosis, a common issue in older adults, shifted center of gravity related to pregnancy, and increased calcium and vitamin D needs in older populations are also important in broader assessment contexts.

Promoting Exercise in Older Adults

Emphasizing warm-up and cool-down phases in exercise routines is essential to prevent injuries and promote safety.
Rapid increases in exercise intensity should be avoided, and clients should be advised not to continue exercising if feeling weak.

Good Posture Guidelines

Proper lying posture mirrors good standing posture, focusing on keeping knees slightly flexed and feet at a right angle relative to the legs.
The head and neck should remain neutral to avoid pressure.

Positioning to Prevent Sliding

The slight Trendelenburg position can help prevent a client from sliding down in bed, ensuring safety and comfort during rest.

Safe Transfers

Positioning the stretcher at the same height as the bed facilitates smoother transfers and reduces the risk of client injury during movement.

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Description

This quiz focuses on the logrolling technique used in nursing, especially for clients post-surgery. Test your understanding of the principles behind maintaining body alignment and preventing skin breakdown during client care.