When a muscle is not moved or exercised, it can shorten and become stiff. Range of motion (ROM)becomes limited and movement can be painful. Prevention is important when a client is immobile or has a disorder that can lead to contractures, such as cerebral palsy or muscular dystrophy. Stretching, performing ROM exercises and using splints can help maintain function.
When lifting any heavy object, start by placing your feet shoulder width apart, about 12-18 inches, with one foot slightly in front of the other. Squat down, bending only your hips and knees. Keep your back straight and shoulders back as you slowly stand. Never twist or turn as you lift. Hold the object close to your body, near your navel.
BID is an abbreviation used in medicine and pharmacy to indicate "two times each day." The medication should be taken every 12 hours. BID is also written as b.i.d. or bid.
The two most common post-operative complications include atelectasis (fluid collecting in the lungs) which can lead to pneumonia, and blood clots, which can break off and travel to the lungs. The nurse aide can help the client turn in bed, as well as take deep breaths and cough, to make sure enough air gets into the lungs. Leg exercises and getting out of bed as soon as possible can increase circulation to avoid blood clots.
Following hip surgery, the client should be positioned to maintain natural alignment of the leg. A pillow ("abductor pillow") or wedge is placed between the legs keeps the legs in the correct position. Ankles and legs cannot be crossed, and toes should point toward the ceiling. The hip should not be rotated inwards or outwards. The client can never lie on the non-operative side.
Before helping any resident walk, take time to assess how much assistance will be needed. Allow the resident to sit at the edge of the bed and dangle their legs before standing. When walking, if the resident becomes weak or dizzy, protect them and yourself by easing the resident to the floor. Do this by holding them under the arms while putting one of your legs forward to support the resident while lowering them to the floor. Keep your knees bent to avoid a back injury.
Rehabilitation is the specialized care that helps a client get the best possible level of function and independence possible. The rehabilitation process is used to restore physical strength and movement after surgery, illness, or trauma. It cannot reverse the damage, but can assist the client to attain a better quality of life.
Range of motion (ROM) exercises provide a way to maintain joint flexibility. In passive ROM, someone moves the joints with no assistance from the client. In active ROM, the client does the exercises alone or with the help of devices, such as a strap. ROM is important to prevent contractures. A contracture is a shortening of muscles, tissues, tendons, and skin at the joints, due to lack of movement and exercise. When joints remain bent over time, they can no longer be straightened.
Arthritis is a common chronic disorder of the joints. It involves pain, swelling, and stiffness that can limit movement. Care of a client with arthritis includes a wide range of ongoing treatments to decrease inflammation and maintain the joints. Stretching, exercise, heat and cold, and anti-inflammatory medications can be helpful.
Bladder training is an effective way to help clients gain control over urinary incontinence. Toileting is scheduled at specific times during the day, including before and after bed. The times between using the bathroom are gradually increased. Bladder training takes about 6-12 weeks.
If a resident is dependent on staff for total care, try to create ways that give the resident a sense of control. During meals, allow the resident to choose the order of foods and beverages. When getting dressed, offer choices of clothing. Ask which television show the resident would prefer. Making decisions gives residents a way to participate in their care.
Restorative care provides specialized services to help a client regain the highest possible health and function and to prevent decline. The goal is to assist the client to return to a home setting and live independently. Rehabilitation methods are used to teach clients activities of daily living, speech, and safety.
A contracture is a shortening of muscles, tissues, tendons, and skin at the joints, due to lack of movement and exercise. When joints remain bent over time, they can no longer be straightened. Range of motion (ROM) exercises provide a way to maintain joint flexibility. In passive ROM, someone moves the joints with no assistance from the client. In active ROM, the client does the exercises alone or with the help of devices, such as a strap.
In passive range-of-motion (PROM), the client's joints are supported and moved by someone else. The client does not participate in the exercises. PROM keeps joints flexible, but does not build muscle. Active ROM is necessary to increase strength.
Helping clients return to their previous state of health includes having them do as much for themselves as possible. Engaging them in activities encourages them to be independent throughout the restorative process. Also, clients who are involved in decision making are more likely to be compliant with treatment.
Range of motion (ROM) exercises provide a way to maintain joint flexibility. Each joint is moved as far as it can comfortably go. The client may feel slight discomfort as the muscles are stretched, but never push beyond the point of pain. If the client reports pain, stop immediately and report to the nurse or therapist.
One of the primary responsibilities of a nurse aide is to monitor the client's skin for any signs of breakdown that could develop into bedsores, also called decubitus ulcers or pressure sores. During baths, dressing, or position changes, inspect the skin for redness, pallor, warmth, or bruising. Reposition at least every two hours, protecting areas that rub together, as well as the bony prominences. Massages to the back and buttocks can promote circulation. Range-of-motion exercises are also helpful. Always report any signs of breakdown to the nurse.
An ombudsman is a trained advocate for clients' rights in a long-term care facility. They assist clients and their families with any issues or disagreements that occur at the facility. Examples are inadequate services, lack of privacy, poor food quality, or problems with other residents. If the client or family is unable to resolve a problem with the staff, an ombudsman can negotiate on their behalf, as well as find other resources to help them.
Even clients who must remain in bed can often still participate in their care. They can move and turn in bed during the linen change. They can assist with their bed bath and perform their own oral care. The nurse aide should encourage the client to do as much as possible.
Proper body positions maintain good body alignment, which is necessary to help the client feel comfortable, as well as avoid complications. Foot supports prevent foot drop by keeping feet in their natural position. Splints can stabilize a limb or joint. A bed cradle protects a part of the body by keeping the weight of sheets and blankets from touching the client.
Using a gait belt when helping a client ambulate allows the client to walk with support and prevent a fall if the client becomes weak. It also reduces back strain for the nurse aide. A gait belt is also used to help a client stand from a sitting position and transfer to a chair.
Proper body mechanics uses the legs to do most of the work. Keep your back straight and locked; do not turn or twist. If you bend, do so at the knees and hips, not the waist. Before lifting or moving a client, assess how much the client is able to do. If you have any doubts, always ask for assistance from a co-worker.
When hearing aids are not going to be in use for several hours or overnight, disengage the battery to make it last longer. The battery can be removed, but it is easier to open the door of the hearing aid and leave the battery inside. Clients with limited vision or poor motor skills will be able to close the door and insert the hearing aid easily. Never leave hearing aids where they can get lost, misplaced, or damaged. A drawer or container are safe storage places.
Hand tremors are the most common type of involuntary movement. There is no cure for tremors. Treatment includes physical therapy, occupational therapy, and medications. Therapy can help clients learn to do many tasks for themselves. Adaptive devices, such as special eating utensils, can support their efforts to be independent.
When clients are recovering from illnesses or accidents, or learning to live with a disorder, special items can be used to help the clients adapt to the situation and be as independent as possible. Two types of health care professionals assist clients with these goals. Restorative medicine is a new branch of medicine that works to restore a client's health, not just treat symptoms. Rehabilitative medicine specializes in treating clients with painful or limiting physical conditions.
