RN Nursing · Stroke · Practice question
A male client has right-sided hemiplegia following a left cerebrovascular accident (CVA). His sitting balance has improved, and he is now able to sit in a wheelchair. To assist the client in transferring from the bed to a wheelchair, which action should the nurse take?
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Instruct the client to take slow, deep breaths while transferring.
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✓
Place the wheelchair on the client's left side.
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Instruct the client to look at his feet.
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Have the client put both arms around the nurse's neck for support.
Answer & explanation
Correct: Place the wheelchair on the client's left side.
When transferring a client with right-sided hemiplegia following a left cerebrovascular accident, the wheelchair should be placed on the client's stronger, unaffected side, which is the left side. This positioning allows the client to lead with and bear weight through the intact left leg and use the stronger left arm to assist with the transfer, maximizing safety and stability. The unaffected side guides the movement, reducing the risk of falls and injury. Instructing the client to take slow, deep breaths is not a standard transfer technique and does not address the mechanics of a safe pivot transfer. Instructing the client to look at his feet is incorrect because clients should be encouraged to look ahead at their destination, which promotes upright posture and balance. Having the client put both arms around the nurse's neck is a dangerous technique that places excessive stress on the nurse's cervical spine and does not provide the client with appropriate leverage or control. The correct placement of the wheelchair on the left, unaffected side is the standard intervention taught in rehabilitation nursing to promote client independence and safety during transfers following stroke-related hemiplegia.
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