NR 224 Exam 3 Study Guide

22 August 2024

NR 224 Exam 3 Study Guide: Activity and Exercise

1. Health Promotion and Maintenance

Promoting health and maintaining physical fitness are key components of patient care. Encouraging patients to engage in regular exercise is essential for improving overall well-being. As healthcare providers, it is important to adopt a holistic approach when developing and implementing an exercise plan tailored to each patient’s needs. This involves discussing exercise recommendations with the patient and collaborating to design a personalized program that suits their lifestyle and goals. Additionally, teaching patients how to calculate their heart rate and incorporate proper warm-up and cool-down sessions (each lasting 5-10 minutes) into their routine is crucial for safe and effective exercise.

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2. Restorative and Continuing Care

Restorative and continuing care focuses on implementing strategies that help patients regain independence and function in their daily activities after acute care is no longer required. This aspect of care is particularly important for patients with chronic illnesses such as coronary heart disease (CHD), hypertension, chronic obstructive pulmonary disease (COPD), and diabetes. By promoting activity and exercise, healthcare providers can assist patients in performing activities of daily living (ADLs) and support their efforts to achieve optimal functioning. The goal is to empower patients to manage their conditions effectively and maintain a good quality of life.

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3. Assistive Devices for Walking: Proper Technique

Proper technique is essential when using assistive devices to ensure safety and effectiveness:

  • Walkers: Patients should hold the walker, take one step, move the walker forward, and then take another step. It is important to lift the device up and move it forward with each step.
  • Canes: The cane should be used on the stronger side. Patients should place the cane forward 15-25 cm (6-10 inches) while keeping weight on both legs. The weaker leg is then moved forward to meet the cane, placing weight on the cane and the stronger leg. Finally, the stronger leg moves past the cane, with weight distributed on the cane and weaker leg.
  • Crutches:
    • 4-Point Gait: This gait provides weight-bearing support on both legs and is the safest option. Patients move the right crutch forward (6 inches), followed by the left foot to the level of the right crutch. Next, they move the left crutch forward and then the right foot.
    • 3-Point Gait: This gait is used when one leg is affected. Patients move both crutches and the weak leg forward, followed by the stronger leg.
    • 2-Point Gait: This method allows partial weight-bearing on both legs and is faster than the 4-point gait, though it requires more balance. Patients move the left crutch and right foot forward together, then the right crutch and left foot together.
    • Swing-to Gait: Suitable for patients with paralysis in both legs, this gait involves moving both crutches together, lifting weight by the arms, and swinging to the level of the crutches.
    • Swing-through Gait: Similar to the swing-to gait, but the patient swings their body weight forward past the crutches.

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4. Proper Measurement for Assistive Devices

Accurate measurement is critical for the correct use of assistive devices:

  • Crutches: The correct crutch length is measured from the axilla down, with the angle of elbow flexion set at 30 degrees using a goniometer. The distance between the crutch pad and the axilla should be 3 to 4 fingers wide.
  • Cane: The length of the cane should match the distance between the greater trochanter (where the hip and leg meet) and the floor.

5. Safety Using Assistive Devices

Ensuring the safety of assistive devices is paramount:

  • Crutches: Patients should be taught how to inspect crutch tops regularly, securely attach rubber tips, and replace worn tips to increase surface friction and prevent slipping. It is important to keep the crutch tips dry, as water can decrease friction. If the tips become wet, patients should dry them with paper or cloth. Additionally, the structure of the crutch should be inspected for cracks in wooden crutches or bends in aluminum crutches, as these can compromise the device’s ability to support weight and alter body alignment.
  • Walkers and Canes: Proper use is essential to avoid the risk of falls. Patients should be instructed on how to use these devices safely and effectively.

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6. Nursing Implications for Assistive Devices

Collaboration with other healthcare professionals, such as physical therapists, is crucial in promoting activity and exercise through the proper use of assistive devices. Nurses play a key role in teaching patients how to use canes, walkers, and crutches effectively. The selection of the most appropriate assistive device depends on the patient’s condition and needs, and nurses must ensure that patients receive proper instruction and support to use these devices safely.

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This comprehensive guide covers the essential concepts of activity and exercise, focusing on health promotion, restorative care, and the proper use of assistive devices. By integrating these principles into patient care, healthcare professionals can enhance patient outcomes and support individuals in achieving and maintaining their optimal level of function.

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