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Assistive Devise

A. Cane
1. types: Single, straight-legged cane, tripod cane
2. nursing care: teach client to hold cane in hand opposite from the affected extremity and to advance cane at the same time the affected leg is move forward

B. Walker
1. mechanical device with four legs for support
2. nursing care: teach client to hold upper bars of walker at each side, then move the walker and step into it

C. Crutches: teaching the client proper use of crutches is an important nursing responsibility
1. ensure proper length
a. when client assumes erect position the top of crutch is 2 inches below the axilla, and 6 inches in front and to the side of the feet
b. client’s elbow should be slightly flexed when hand is on the hand grip
c. weight should not be borne by the axillae
2. crutch gaits
a. four – point gait: used when weight bearing is allowed on both extremities
1. advance right crutch
2. step forward with left foot
3. advance left crutch
4. step forward with right foot
b. two-point gait: typical walking pattern, an acceleration of four – point gait
1. step forward moving both right crutch and left leg simultaneously
2. step forward moving both left crutch and right leg simultaneously.
c. three-point gait: used when weight bearing is permitted on one extremity only
1. advance both crutches and affected extremity several inches, maintaining good balnce
2. advance the unaffected leg to the crutches , supporting the weight of the body on the hands
d. Swing-to( through) : used for clients with paralysis of both lower extremities who are unable to lift feet from floor
1. both crutches are placed forward
2. clients swings forward to the crutches