A nurse is teaching a 65-year-old client with osteoarthritis who has been prescribed a walker about proper use. Which statement by the client indicates correct understanding of walker safety?
1I should move the walker forward first, then step into it with my affected leg, followed by my unaffected leg.✓ 정답
2I need to lean forward on the walker for support when I'm feeling tired or unsteady.
3I should lift the walker completely off the ground with each step to move it forward.
4I can use the walker to help me get up from a chair by pulling myself up on the handles.
해설
The client's statement about moving the walker first, then the affected leg, then the unaffected leg shows correct understanding of the three-point gait. Other statements involve unsafe practices like leaning forward or lifting the walker.
Clinical Judgment
This question assesses an elderly patient's understanding of safe use of mobility aids after discharge following hip replacement surgery. The key points are fall prevention and the correct sequence for using a walker. The correct answer is to move the walker forward first, then step forward with the weaker (operated) leg, followed by the stronger leg. This sequence ensures the walker always provides a stable support base when the patient bears weight.
Memory Tip
A mnemonic to remember the walker sequence: Walker, Affected, Unaffected (WAU). "Walker (W) first, then the Affected leg (A), and finally the Unaffected leg (U)."
KR vs US
In Korea, education on walker use can be overlooked because patients often receive help from family or caregivers, whereas in the United States, there is a strong emphasis on independent mobility and self-care. Therefore, systematic education and evaluation on the use of walkers and canes are essential components of discharge teaching.
임상 시나리오
Clinical Practice Guide
Patient education points for using a walker:
1. Posture: Straighten your back, lift your head, and look forward while walking. Do not lean or rest your body on the walker.
2. Height adjustment: When standing with your arms hanging down, adjust the handgrips to wrist height. Your elbows should be bent about 15-30 degrees.
3. Moving: Do not lift the walker; instead, push it forward while keeping it in contact with the floor.
4. Standing up from a chair: Hold the armrests of the chair to stand up, balance yourself, and only then grasp the walker's handgrips. Pulling yourself up by grabbing the walker is extremely dangerous.
Caution
These are common trap statements in SATA (Select All That Apply) questions: "Resting by leaning on the walker," "Lifting the walker to move," and "Pulling the body up with the walker" are all incorrect methods that increase the risk of falls. Always check the sequence: "walker first, weak leg, strong leg."
핵심 개념
Walker — Walker. A mobility aid with four legs that helps support body weight and maintain balance using upper body strength.
Gait — Gait. It refers to the manner or style of walking, and when using a walker, a specific sequence (walker-weak leg-strong leg) is followed.
Fall Prevention — Fall prevention. One of the most important safety goals in elderly patient care, proper use of a walker is a key strategy.
Weight-Bearing — Weight bearing. This refers to the degree of weight support allowed for a patient after surgery (e.g., non-weight bearing, partial weight bearing, full weight bearing), and using a walker helps adhere to weight-bearing restrictions.
Assistive Device — Assistive devices. A general term for tools that aid a patient's mobility and daily activities, such as walkers, canes, and crutches.