Lab Guide 15

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Questions and Answers

What should a patient with a spinal cord injury (SCI) do to prevent pressure sores while seated in a wheelchair?

Remain in the same position for extended periods.

Adjust their position every 15–30 minutes. (correct)

Sit with no lumbar support for better stability.

Only shift positions after feeling discomfort.

Which leg should be blocked when both legs are partially reliable but one is stronger?

Neither leg should be blocked for a smoother transfer.

The weaker leg to provide stability. (correct)

The stronger leg to maximize support.

Both legs should be blocked for safety.

When helping a patient with a right total hip arthroplasty (THA) from supine to sitting, what position should they log-roll into?

Supine position since it's the safest.

A sitting position directly to prevent falls.

The right (surgical) side to facilitate easier movement.

The left (non-surgical) side to maintain comfort. (correct)

For a patient with a right cerebrovascular accident (CVA), which direction is ideal for transferring from bed to wheelchair?

To the left side (strong side) to facilitate assistive movements. Signup and view all the answers

What is the recommended transfer type for a patient with generalized weakness but able to bear weight on both legs?

A squat pivot transfer to allow weight support. Signup and view all the answers

What distinguishes a squat pivot transfer from a stand pivot transfer?

The squat pivot requires the patient to remain in a partial squat. Signup and view all the answers

Which transfer method is best for a person with spinal cord injury and limited range of motion in both legs when transferring from a wheelchair to the floor?

An anterior-posterior (A-P) transfer for better control. Signup and view all the answers

For a patient with right CVA transitioning from sidelying to sitting, which side should they move toward?

The left side to make use of the unaffected side. Signup and view all the answers

What is a critical consideration when performing lateral transfers for a patient who cannot bear weight through the lower extremities (LEs)?

Using a mechanical lift Signup and view all the answers

Which transfer method should be utilized for a patient with hemiplegia and limited control on one side?

Squat-pivot transfer Signup and view all the answers

When transitioning a patient with a right total hip arthroplasty (THA) from supine to sitting, which initial strategy is advisable?

Log-roll to the right side Signup and view all the answers

What preferred method of transfer is often recommended for patients who have some weight-bearing through both legs but exhibit generalized weakness?

Squat-pivot transfer Signup and view all the answers

In patients with limited range of motion (ROM) in the lower extremities following a spinal cord injury (SCI), which transfer is best when moving from a wheelchair to the floor?

Forward slide transfer Signup and view all the answers

For a patient with right cerebrovascular accident (CVA), which direction is typically safer during transfers?

Transferring to the left side Signup and view all the answers

What differentiates a squat-pivot transfer from a stand-pivot transfer?

The requirement of knee bending Signup and view all the answers

In the context of transfers, what is a necessary adjustment for patients with unilateral weight-bearing restrictions?

Blocking the stronger leg during the transfer Signup and view all the answers

What is the most appropriate transfer direction for a patient with SCI and pain in the right upper extremity moving from a wheelchair to a floor?

Transfer toward the left side Signup and view all the answers

For a patient recovering from a left CVA, which method is most appropriate for transferring from bed to a gurney when they cannot move independently?

Pivot transfer toward the weaker side Signup and view all the answers

When transferring a patient who is 320 lbs and has significant weakness in extremities, which transfer option is recommended?

Two-person lift with assistance Signup and view all the answers

In preparing for a transfer from bed to wheelchair for a patient with a total knee arthroplasty, what factor is the most relevant to consider?

Weight-bearing status on the affected leg Signup and view all the answers

What is the key strategy to employ during a transfer for a patient with limited range of motion in the right upper extremity?

Minimizing movement of the affected extremity Signup and view all the answers

Which transfer technique is generally preferred for a semi-comatose patient who cannot participate in moving from bed to gurney?

Two-person assistive transfer Signup and view all the answers

For a patient who is unable to move due to extreme weakness and paralysis, what is the recommended approach for a safe bed to gurney transfer?

Direct mechanical lift Signup and view all the answers

During the transfer of a patient that is fearful and refuses to put weight on the affected leg after TKA, which technique should be utilized?

Providing verbal reassurance while facilitating movement Signup and view all the answers

What is the most appropriate transfer direction for a patient with spinal cord injury (SCI) who has pain and limited range of motion in their right upper extremity?

Transfer towards the left side Signup and view all the answers

When assisting a patient with a right CVA to move from sidelying to sitting, which side should they utilize for support?

Left side Signup and view all the answers

What is the ideal technique for a patient with generalized weakness who can bear weight on both legs during a transfer?

Squat pivot transfer Signup and view all the answers

Which transfer type is recommended for a patient with a total hip arthroplasty (THA) to avoid hip flexion beyond 90 degrees?

A log-roll to the non-surgical side Signup and view all the answers

What distinguishes a squat pivot transfer from a standard pivot transfer?

The squat pivot does not require complete standing Signup and view all the answers

What is the best method for a patient with limited range of motion in their bilateral lower extremities to transfer from a wheelchair to the floor?

Anterior-posterior transfer Signup and view all the answers

In what manner should pressure relief techniques be performed by a patient using a wheelchair?

Every 15-30 minutes by leaning side-to-side or slightly lifting Signup and view all the answers

If a patient is transitioning from bed to a wheelchair following a right CVA, which structure should be emphasized to assist them?

The stronger left side Signup and view all the answers

Study Notes

Patient Transfers and Positioning

SCI Patient in Wheelchair: Ensure upright posture with lumbar support. Perform pressure relief every 15-30 minutes to prevent sores.
Right CVA Patient: Transition from sidelying to sitting on the left side (stronger side) for easier transfer.
Partial Leg Reliability: Block the weaker leg during transfers for stability.
Right Total Hip Arthroplasty: To avoid hip flexion, log-roll onto the left side, then push up to a sitting position while keeping the right leg extended.
Right CVA Bed to Wheelchair Transfer: Transfer towards the left side for patient assistance.
Generalized Weakness with Weight Bearing Ability: A squat pivot transfer is ideal for minimized standing needs.
Squat Pivot vs. Stand Pivot:
- Squat Pivot: Partial squat, for limited strength/stability.
- Stand Pivot: Full standing, for more independence and requiring greater strength.
SCI with Limited Leg ROM: Anterior-posterior (A-P) transfers are ideal for floor transitions, minimizing leg movement.
SCI with Right Upper Extremity Pain/Limited ROM:
- For Wheelchair to Floor: Side transfer towards the left reduces strain on the right side.
- For Wheelchair to Bed: Transfer towards the left side to minimize right arm usage.

Transfer Techniques

Lateral/horizontal transfers: For patients who cannot bear weight through their lower extremities (LEs).
Squat- or standing-pivot transfers: For patients who can bear weight through their LEs.
Blocking of the knees: May be necessary during pivot transfers.
Modifications to transfer techniques: May be necessary for patients with unilateral weight-bearing limitations, hemiplegia (one-sided weakness/paralysis), or following total hip arthroplasty (THA) or spinal cord injury (SCI).
Vertical transfers: Include the extra challenge of gravity and require good upper extremity range of motion and strength.
One smooth movement: As patients become more skilled, their transfers may occur in one smooth motion vs. being broken down into smaller steps.
Multiple vertical transfer methods: Patients may develop their own preferred method for each specific situation.

SCI Considerations

Wheelchair positioning: Advise patients to sit upright, ensure proper lumbar support, and adjust positioning regularly.
Pressure relief: Encourage patients to perform pressure relief techniques every 15 to 30 minutes.
Transfer Direction: Transfer toward the left side for SCI patients with pain/limited ROM in their RUE, reducing strain on the affected side.
Wheelchair to floor transfer: Use an anterior-posterior (A-P) transfer if the patient has limited BLE range of motion.

CVA Considerations

Sidelying to sitting transition: Easier on the left side (strong side) for right-sided CVA patients.
Bed to wheelchair transfer: Transfer the patient toward the left side (stronger side) for right-sided CVA patients.

THA Considerations

Supine to sitting EOB: Log-roll the patient to their left side, then use their arms to push up to sitting while keeping the right leg extended.

General considerations

Generalized weakness, able to bear weight: A squat pivot transfer is recommended to minimize the need for a full stand.
Limited strength/stability: A squat pivot transfer is recommended.
Full strength: A stand pivot transfer provides more independence.
Patient with significant weight: Consider using additional assistants for safety.
Postoperative patient: Determine if they can bear weight before attempting a transfer.

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Description

This quiz covers essential techniques for transferring patients, particularly those with specific conditions like spinal cord injuries and strokes. You'll learn the best practices for positioning, wheelchair transfers, and comparing squat and stand pivot transfers. Healthcare professionals will find this information vital for safe patient care.