Question

For the following case studies, develop a progression of transfer activities appropriate for progressing a patient from dependent to independent (as much as feasible) transfer status. Note transfer activity methods, amount, and type of assistance.

1. The patient is an 18-year-old male who sustained a complete T12–L1 spinal cord lesion in a motorcycle accident 2 weeks ago. Following surgery, he is wearing a thoraco-lumbar-sacral orthosis (TLSO). He has medical clearance to begin transfer activity training while wearing his TLSO.

2. The patient is a 23-year-old female with cerebral palsy presenting with spastic quadriplegia. While living with her parents, her father lifted her for all transfer activities. Following her recent college graduation, she is living in a group home for the first time. She ambulates by using a power wheelchair. The staff of the group home requests assistance in selecting appropriate transfer activities. The staff would like a program to assist her in becoming an active participant in her transfer activities. Would the transfer activity method selected be different if she was 5 feet tall weighing 250 pounds, versus 5 feet tall weighing 96 pounds?

Answer 1

1. First of all the patient's pre-existing coping abilities play an important role in the adaptation process. In this ,patient may be particularly dependent and seems to be lack personal power. The main goal is to help the patient to get a positive self-image through effective coping.The nurse must recognise different coping abilities and identify the patient needs.

Using nursing process, the nurse develops a plan of care designed to facilitate rehabilitation , restore and maintain optimum health, and prevent complications.The nurse helps the patient identify strengths and past successes and develop new goals. The nurse is often the case manager, responsible for cordinating the total rehabilitative plan, collaborating with and coordinating the servicesprovided by all members of the health care team will be resposible for patient's care.

The nurse assist the patient with transfer. The nurse assesses the patient's ability to participate actively in the transfer and determines in conjuction with an occupational therapist or physical therapist the required adaptive equipment to promote independence and safety. It is important that the patient maintain muscle strength. The nurse or physical therapist teaches the patient how to transfer.There are several methods of trasferring from bed to the wheelchair when the patient is unable to stand, and the technique chosen should be appropriate for the patient, considering his abilities and disabilities.

2. The weight also plays an important role in the transfer activity of the patient. The transfer ctivities may vary according to the patient condition. The occupatioal therapy helps to improve the child's ability, and helps to assess the need for various assistive devices. These devices are uesd to prevent or correct deformities in the spastic limb or to help the child to overcome activity limitations , such as difficulties with standing and walking.