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Module 7-bed mobility + Txrs

when should u assess the pt's pain level? before and at the completion of txr.
how and y would you move a pt side to side in bed? segmentally (scap, pelvis, feet. **if they can assist w/bridging, have them!) or with sheet. to prepare for a roll to side, maybe to get up, to change sheets.
how and y can you move a pt up/down in a bed? (1 person vs 2 person) (*first move them close 2 ur side!) 1 person: pt can assist u wi/ bridging. or pull sheets @ head (palms facing down!). 2 pers- 1 on ea side of sheet. used 2 reposit pt for comfort/posit. used to prepare before rolling to sitting to get out of bed.
what's key when having a pt do a bridge (what are key things to instruct them with)? push through ur heels and lift hips up towards the ceiling.
when moving a pt up in bed, do not attempt to move the lower trunk + pelvis upward more than ____ inches at a time. 6-10". if u need to do more. reposition yourself and the pts LE and repeat. (same for moving down in a bed)
how and y can u move a pt from supine 2 sidelying? ensure enuf room 2 roll 2 side, stand in front when u roll them! 1 pers- bend pt knee, push w/other if they can, u contact scap + GT. 2 pers- logroll (T'+L'). 3 pers- logroll w/ T,L,+C. other- use sheet under pt. key phrase " toward PT Left or Right.
supine 2 sit? how and y? move pt close to 1 edge. dept Max A: use counterbalance of LE and UE to swing into sit. Mod A-Indep A: have them assist with UE! get them to sit to prepare for activity, amb, eat lunch, bed sores, etc.
supine 2 sit with THA precautions? THA pt? txr to strong side but also consider their preference @ home. scoot legs to side (no ADD!) stay semi-reclined (aka "long sit"). move slowly!
Bed to/from W/C. what must u first do W/C positioned 45-60 degrees, apply safety belt, LOCKED, remove arm rest and swing leg out. usually easiest for pt to txr while leading with their strong side.
bed 2 W/C? Indept/some assistance? stand pivot (txr 2 strong side; lean upper body away 2 deweight, ensure ur foot placement correct with 1 ft in direction of bed and chair, encourage "nose over toes"/rocking, block knee closest 2 txr surface w/ both ur knees.)
bed 2 W/C dependent txr? for a NWB LE: similar. WC on same side as FWB extremity,, but block strong LE (foot outside, knee inside). u can encourage NWB LE on top of urs to ensure No WB.
Txr board? how? get pt sitting, lower bed to same height as WC (locked, casters fwd, angled towards bed, arm rest removed, legs out). LEs on bed/over side. de-weight 1 side + posit board under upper thighs/bottom+ other chair seat (45 deg), wieght shift and scoot across!
what should you document for a pt's bed mobility/txrs? Type of txr, lvl of assist, amt of time (good objective measure that theyre still improving even tho they remain Max A.), lvl of safety, quality of momt, precautions 4 txr, lvl of consistency of the performance, any equip required- TLSO, txr board, walker
Created by: tpostrel