NCLEX Review Guide: Canes and Walkers

Cane Usage and Safety

• Proper cane height is measured from the greater trochanter to the floor, with elbow flexed at 15-30 degrees when holding the cane.
• The cane should be held on the stronger/unaffected side to provide maximum support and stability during ambulation.
• When ascending stairs: good leg goes up first, followed by the affected leg and cane together.
• When descending stairs: cane and affected leg go down first, followed by the good leg.

Walker Types and Techniques

• Standard walkers require lifting with each step and provide maximum stability for patients with significant balance issues.
• Rolling walkers have wheels on front legs only, allowing for smoother forward movement while maintaining rear stability.
• Four-wheeled walkers include hand brakes and seats but require good cognitive function and hand strength to operate safely.
• Walker height should allow elbow flexion of 15-30 degrees when hands are placed on handgrips.

Environmental Safety

• Remove throw rugs, electrical cords, and clutter from walkways to prevent tripping hazards.
• Ensure adequate lighting in all areas, especially stairways and bathrooms where falls commonly occur.
• Install grab bars in bathrooms and handrails on both sides of stairways for additional support.
• Keep frequently used items within easy reach to avoid overreaching or bending that could cause loss of balance.

Proper Walker Technique Steps

1. Position walker arm's length away
2. Step forward with weaker leg first
3. Step forward with stronger leg
4. Advance walker again before next step cycle

NCLEX Success Strategies

• Remember that safety is always the priority when selecting and teaching assistive device use.
• Focus on proper body mechanics and device fit to prevent injury and promote independence.
• Consider patient's cognitive status, upper body strength, and balance when recommending devices.