Chapter 33 Mobility PrepU

The nurse is performing an assessment of an older adult client. What finding does the nurse document as a normal age-related change?

A decrease in the flexibility of joints is a normal age-related finding. Pain in the lower back, stumbling gait, and unequal pupil can be indicators of pathology and are not normal age-related findings.

Which client would the nurse place in a protective prone position?

A nurse would place a client prone to hyperextension of the spine in a protective prone position. A nurse would place a client prone to edema of the hand in Fowler's position. A nurse would place a client prone to internal shoulder rotation and adduction in protective supine position. A nurse would place a client prone to flexion contracture of the neck in protective supine position.

The nurse is planning care for a client with a nursing diagnosis of Activity Intolerance. What assessment finding would cause the nurse the most concern?

Activity Intolerance may result from any condition that interferes with the transport of oxygenated blood to tissue. The altered response to activity includes exertional dyspnea, shortness of breath. Shortness of breath after walking up five stairs would be included in this nursing diagnosis. Another altered response would be excessive increase in pulse rate. After walking up 20 stairs, a change in pulse of 4 points is not excessive. Joint stiffness is a defining characteristic of the nursing diagnosis Impaired Physical Mobility. Walking with a slow and uncoordinated movement is another defining characteristic of Impaired Physical Mobility.

The nurse is assessing the client for muscle mass, tone, and strength and determines that there is increased tone that interferes with movement. How does the nurse document this finding?

Adequate skeletal muscle mass, tone, and strength are prerequisites to appropriate body movement and work performance. Spasticity, or hypertonicity, is defined as increased tone that interferes with movement. Spasticity is caused by neurologic impairments, and is often described as a stiffness, tightness, or pulling of the muscle. Hypertrophy refers to increased muscle mass resulting from exercise or training. Atrophy describes muscle mass that is decreased through disuse or neurologic impairment. Flaccidity, or hypotonicity, results from disuse or neurologic impairments, and is described as a weakness of paralysis

When assessing the physical activity of clients, the nurse would be most concerned about which client?

Although further assessments should be done to avoid making assumptions and imposing stereotypes, there are many variables that may contribute to a sedentary lifestyle, such as occupations. A computer programmer has a job that is inactive. The nurse would be concerned about this client and would need to do further assessments to determine activity, frequency, and intensity that occur outside of work. The mother of small children would be involved in housecleaning and chasing after the children. Walking is a commonly prescribed exercise, and going to the mall provides a safe environment where walking would be possible. A Native American who hunts is engaging in culturally related physical activity.

The nurse is caring for a client who is on bed rest. After revieiwng the image above, which is the most appropriate reason for the nurse to observe this client perform the activity?

Assisting and observing the client perform dorsiflexion of the feet helps to reduce the risk of foot drop. Foot drop can occur if the toes of the feet are dropped downward for extended periods of time resulting in plantar flexion caused by changing the length of the muscles. Due to the gravitational pull, this position of the feet occurs naturally when the body is at rest and the toes are placed in a perpendicular position making heel-toe gait impossible. This results in altered mobility. Wearing shoes such as a high-top canvas sneaker could assist to minimize this complication of prolonged bed rest.

The nurse is assessing the developmental level of children in a pediatric clinic. The nurse would be most concerned about which client?

At 15 months of age, most toddlers can walk unassisted; there would be concern for a 24-month-old child who could not. At 3 months of age, an infant may be able to raise the head, but this is not expected at this age. Rolling over is usually accomplished between 6 and 9 months of age, so it would not be expected for all 6-month-old infants. Stacking blocks is accomplished by most 3-year-olds, but doing so at 18 months is considered early.

The nurse is assessing a client who has presented at the ambulatory care unit. The nurse notes the client has impaired muscle coordination. The nurse correctly documents the presence of:

Ataxia refers to a lack of muscle coordination. Tremors are rhythmic, repetitive movements. Chorea is spontaneous, brief, involuntary muscle twitching of the limbs or facial muscles. Athetosis refers to movement characterized by slow, irregular, twisting motions.

A nurse receives an order to apply graduated compression stockings for a client at risk for venous thromboembolism. How should the nurse apply the stockings?

Be prepared to apply the stockings in the morning before the client is out of bed. Assist the client to a supine position. If the client has been sitting or walking, have him or her lie down with legs and feet well elevated for at least 15 minutes before applying the stockings. Powder the leg lightly unless client has a breathing problem, dry skin, or sensitivity to the powder. If the skin is dry, a lotion may be used. Powders and lotions are not recommended by some manufacturers; check the package material for manufacturer specifications.

Which type of mobility aid would be most appropriate for a client who has poor balance?

Canes with three (tripod) or four prongs (quad cane) or legs to provide a wide base of support are recommended for clients with poor balance. Single-ended canes with half-circle handles are recommended for clients requiring minimal support and those who will be using stairs frequently. Single-ended canes with straight handles are recommended for clients with hand weakness because the handgrip is easier to hold but are not recommended for clients with poor balance. Axillary crutches are used to provide support for clients who have temporary restrictions on ambulation

Which exercises would the nurse recommend when planning isometric exercise for a client? Select all that apply.

Contracting the quadriceps, Kegel exercises, and contracting and releasing the gluteal muscles are isometric exercises that the nurse might recommend to a client. Jogging, range-of-motion exercises, and bicycling are isotonic exercises.

A client who has an immobilizer on the arm reports shortness of breath following ambulation to the bathroom. The nurse notes the client's pulse increased from 82 to 124 beats/min, respirations increased from 16 to 24 breaths/min, and blood pressure is 90/50 mmHg. The nurse makes the nursing diagnosis of Activity Intolerance. What are the client's defining characteristics for this diagnosis? Select all that apply.

Defining characteristics for the nursing diagnosis Activity Intolerance include the client's report of shortness of breath with activity, increased pulse rate, increased respiratory rate, and decrease in blood pressure. Limited range of motion is a defining characteristic for the nursing diagnosis Impaired Physical Mobility.

The nurse is caring for an 84-year-old client. While assessing the client, the nurse notes that the client has an unsteady gait and weak muscle strength and tires easily with physical exertion. How will the nurse document this finding?

Disuse syndrome is the appropriate documentation of this client finding. Energy is the capacity to do work. Alignment is the part of an object in proper relationship to others. Functional position is the position in which an activity is properly and normally performed. Therefore low energy, poor alignment, and functional position are not how the nurse would document this finding.

A client has been prescribed graduated compression stockings to wear for the next three weeks. The nurse will implement which interventions? Select all that apply.

Each leg should be measured, and stockings ordered to fit. If there is difference between the size of the legs, the nurse should order two sizes of stockings. At least two pairs of stockings must be ordered so that the client has a pair to wear while the other pair is being laundered. The stockings should be put on for the first time in the morning before the client gets out of bed. The stockings should be removed each day, but the legs should not be massaged. The stockings should be laundered regularly, at least every three days.

The nurse has been educating the client about how to use a walker safely. The nurse knows that the education has been effective when the client:

A walker is mechanical aid that enhances the client's balance and ability to bear weight. Education is usually done by physical medicine or physical therapy, but the nurse should continue to assess the client's ability to use the walker properly. The client should step into the walker when walking rather than walking behind it. When the client is rising from a seated position, the arms of the chair, not the walker, should be used for support. The client should be cautioned to avoid pushing the walker out too far in front. Also, the client should avoid leaning over the walker but should instead stay upright while moving.

A client with limited mobility has outward rotation of the bony protrusions at the head of the femur. Which assistive device would the nurse include in the plan of care?

Trochanter rolls prevent the legs from turning outward. The trochanters are the bony protrusions at the heads of the femurs, near the hip. Placing positioning devices at the trochanters helps prevent the legs from rotating outward. Other devices are inappropriate for this client.

Using proper body mechanics, which motions would the nurse make to move an object?

Use the internal girdle and a long midriff to stabilize the pelvis and to protect the abdominal viscera when stooping, reaching, lifting, or pulling. The internal girdle is made by contracting the gluteal muscles in the buttocks downward and the abdominal muscles upward. It is helped further by making a long midriff by stretching the muscles in the waist. The nurse would not relax the stomach muscles or use the muscles of the back when moving an object. The nurse would not lift an object when it can be safely slid, rolled, pushed, or pulled.

A nurse is logrolling a client who has a spinal injury. Which nursing action follows the recommended guidelines for this procedure?

When a client has a spinal injury or is recovering from neck, back, or spinal surgery, it is often necessary to keep the body in straight alignment when turning the client. Two or three nurses can accomplish this safely by logrolling a client. Do not try to logroll the client without enough help. Do not twist the client's head, spine, shoulders, knees, or hips while logrolling. A friction-reducing sheet is used for other transfers, but not with the logrolling technique. The nurse would have a client cross the arms on the chest with other transfers, but not with the logrolling technique. A nurse should be on both sides of the bed of a client who is being logrolled, not just on the side that the client is being turned.

After positioning a client to move from the bed into a wheelchair, how would the nurse stand when helping the client sit up on the side of the bed?

When assisting the client from the bed into a wheelchair, the nurse would take position near the client's hip, with legs shoulder width apart and one foot near the head of the bed. This ensures that the nurse's center of gravity is placed near the client's greatest weight to assist the client to a sitting position safely. The dominant or nondominant side is not relevant when moving a client with equal strength but would be helpful with a client who has had a stroke.

The nurse is assisting an older adult client with dementia in getting dressed after morning care. Which statement would be most beneficial to the client?

When communicating with a client with dementia, instructions should be given in clear, short sentences that offer simple, step-by-step instructions. "Put your arm in this sleeve" gives one step in the process of getting dressed. "Put on your shirt" involves many steps and should be broken down into the steps of putting on a shirt. "Put your pants on and zip the zipper" should be broken down into steps and given in clear, short sentences. Furthermore, putting on pants and zipping a zipper involves many steps and may be too complicated for the client with dementia to follow. Instructions should be phrased positively as the client may not register the "Don't"; the client may put the shoes on if the nurse states "Don't put on your shoes yet."

The nurse adjusts a client's bed to a comfortable working height in order to turn the client. What would be the nurse's next action?

When turning a client in bed, the nurse would use a friction-reducing sheet to pull the client to the edge of the bed that is opposite the side the client will be turning. Pushing the client to the opposite side of the bed is not good for back safety. Consult a Safe Patient Handling algorithm to determine whether assistive devices or additional nurses are needed, depending on the individual client.

A client has undergone foot surgery and will use crutches in the short term. Which teaching point should the nurse provide to the client?

When using crutches, the elbow should be slightly bent at about 30 degrees and the hands, not the armpits, should support the client's weight. Supervision of the client learning to use crutches should not be performed by unlicensed assistive personnel (UAP). The client should stop ambulating and sit down, if fatigued.

deep vein thrombosis

blood clot forms in a large vein, usually in a lower limb

Thrombus formation

blood clot that remains attached to the vessel wall

thrombus formation risk factors

intimal injury/inflammation, obstruction of flow, pooling (stasis)

On a previous clinic visit a month ago, an overweight client reported shortness of breath with activity and constipation. The client was diagnosed as having osteoporosis and noted to have an elevated triglyceride level. The primary care provider prescribed an exercise program. The nurse is assessing for the effects of exercise. What are the expected outcomes for this client? Select all that apply.

Effects of an exercise program include improved work of breathing (no shortness of breath with activity), improved bowel elimination (regular and formed bowel movements), and weight controlled at the current weight, or ideally lessened. The client's blood triglyceride level should decrease with an effective exercise program. The client should experience increased joint mobility and less joint pain.

The nurse has been educating a client about health promotion and exercise. What statement made by the client demonstrates that the education has been successful?

Exercising with a friend will add the support of a buddy. Joining a spa, health club, or exercise group is also recommended to provide support to exercise. Exercise sessions should be introduced gradually to prevent overexertion and injury to muscles. Clients should be encouraged to exercise for 30 to 45 minutes 3 or 4 times per week. Alternating types of exercise will help prevent boredom.

The nurse has asked the client to grasp his overbed trapeze and pull his torso up off the surface of the bed. What movement will the client perform with his arms?

Flexion is achieved when a body part is bent, as when the elbow is bent and the upper arm and forearm are brought together. Adduction and abduction denote lateral movement to and from the body, and dorsiflexion is backward bending of the hand or foot.

The nurse is assisting the client who has dementia from the bed to the chair for mealtime. What actions by the nurse would facilitate cooperation from the client? Select all that apply.

For the client who has dementia, the nurse would facilitate cooperation by calling the client by the preferred name, facing the client when speaking, and providing instructions one at a time. The nurse would use a calm and reassuring tone with the voice, not a forceful tone. Clients with dementia respond better to statements that are positive, rather than those statements that have a negative connotation or the word "don't."

The nurse is encouraging the client to use hand rolls to prevent contractures. Which statement by the client indicates that further teaching is necessary?

Hand rolls prevent contractures (permanently shortened muscles that resist stretching) of the fingers. They keep the thumb positioned slightly away from the hand and at a moderate angle to the fingers. The fingers are kept in a slightly neutral position rather than a tight fist. A rolled-up washcloth or a ball can be used as an alternative to commercial hand rolls. Hand rolls are removed regularly to facilitate movement and exercise. Hand rolls are not used to strengthen the grip.

The nursing assistant is preparing to help the client make a lateral transfer from the bed to a stretcher. The client informs the nurse that the client is able to move onto the stretcher without the nurse's help. What is the nurse's best response?

If the client is fully able to assist in the transfer, the nurse should allow the client to complete the movement independently, with supervision for safety. A physician order is not necessary for a transfer from a stretcher to a bed. The client can move independently and therefore does not need a friction-reducing device. A nurse should remain at the bedside to monitor the transfer.

The nurse is applying graduated compression stockings to the legs of a postsurgical client. The client suddenly complains of sharp pain to his left leg as the nurse is unrolling the stockings. What is the nurse's most appropriate action?

If the pain is unexpected, notify the primary care provider because the client may be developing a deep vein thrombosis. Applying padding would be an insufficient response, and it would be dangerous to proceed with applying the stocking.

A nurse is assessing a client's mobility status. What data would the nurse document as normal findings? Select all that apply.

Normal findings that the nurse would document regarding a client's mobility would include independent maintenance of correct alignment, full range of motion, and the alignment of the client's head, shoulders, and hips in bed. A fasciculation is a muscle twitch, which would not be a normal finding regarding a client's mobility. The documentation of a client having a scissors gait would not be a normal finding. Increased joint mobility would not be a normal finding regarding the client's mobility.

The nurse is performing a physical assessment on an adolescent. What assessment priorities are needed for this age group?

Numerous factors, including growth and development, influence a person's posture, movement, and daily activity level. The adolescent should be assessed for scoliosis (curvature of the spine). Kyphosis is increased convexity in the thoracic spine from disk shrinkage and decreased height, common in older adults. A shifted center of gravity occurs during pregnancy (in the adult) because of the developing fetus. Older adults have an increased need for calcium and vitamin D related to the risk for osteoporosis.

The nurse is teaching a client about good posture when lying down to go to sleep. Which teaching will the nurse include?

The best posture lying down will be the same as standing posture, except the client is horizontal. Knees should be slightly flexed; feet should be at a right angle from the legs; the head and neck muscles should be in a neutral position, centered between the shoulders. It is not correct to say to keep the knees and legs very straight, to position feet at a 45-degree angle from the legs, or to sleep with the head tilted to one side.

The nurse is positioning a client with limited mobility who is lying down to go to sleep. Which positioning technique is most appropriate?

The best posture lying down will be the same as that for standing posture, except the client is horizontal. Knees should be slightly flexed; feet should be at a right angle from the legs; the head and neck muscles should be in a neutral position, centered between the shoulders.

The client is ambulating in the room and walks around a bedside table. What is the best explanation for why the client does not bump into the table?

The client has awareness of spatial relationships (where objects are located in space). This ability comes from the visual or optic reflexes. The labyrinthine sense relates to the sensory organs in the inner ear and provides a sense of position, orientation, and movement. It does not contribute to where objects are in space. When the extensor muscles are stretched beyond a certain point, their stimulation causes a reflex contraction that aids a person to reestablish erect posture (e.g., when the knee buckles under, the reflex contraction aids the person to straighten the knee). This does not contribute to perception of where objects are in space.

The nurse is delegating inactive client positioning to a UAP. What directions will the nurse include?

The inactive client should be repositioned every 2 hours with the use of a low-friction fabric or gel-filled plastic sheet and then placed in good alignment with joints slightly flexed. Skin care should be provided after repositioning.

A nurse is teaching a client how to use a walker. Which instructions should the nurse provide? Select all that apply.

Regardless of the type of walker used, the client stands between the back legs of the walker with arms relaxed at the side, the top of the walker should line up with the crease on the inside of the client's wrist. When the client's hands are placed on the grips, elbows should be flexed about 30 degrees. Have the client move the walker forward 6 to 8 in (15 to 20 cm) and set it down, making sure all four feet of the walker stay on the floor. Then, tell the client to step forward with either foot into the walker, supporting himself or herself on his or her arms. Follow through with the other leg.

When working with a client who has a fractured wrist, the nurse applies what knowledge about the bones in the body?

Short bones contribute to movement and are located in the wrist and ankle. The wrist is classified as a short bone. Long bones, such as the femur and humerus, are located in the upper and lower extremities and contribute to height and length. The flat bones are relatively thin and contribute to shape. The flat bones are found in the ribs and several of the skull bones and contribute to shape (structural contour).

The nurse is preparing the client for the administration of an enema. The nurse will place the client into which position?

Sims' position is used for the procedures involving the rectum and vagina. The other options are incorrect for this client.

The nurse recognizes that which organization requires that employers comply with ergonomic recommendations?

The National Institute for Occupational Safety and Health (NIOSH) requires compliance with ergonomic recommendations. The Joint Commission (TJC) is an accrediting body for healthcare organizations. The American Nurses Association (ANA) is directed toward nursing professionals. The National League for Nursing (NLN) promotes excellence in nursing education.

A nurse is teaching a client about the beneficial effects of exercise on his body. Which education point would the nurse include in the plan? Select all that apply.

The benefits of exercise include increasing intestinal tone, increasing efficiency of the metabolic system, and increasing blood flow to the kidneys. Exercise decreases resting heart and blood pressure. Exercise increases appetite. Exercise increases the rate of carbon dioxide excretion.

In an assessment for proper body alignment of a standing client, which finding is normal?

A client's body is in correct body alignment while standing when the weight of the body is distributed on the soles and heels. The chest is held upward and forward. The abdominal muscles are held upward and the buttocks downward. The line of gravity goes midline through the center of the knees and in front of the ankle joints.

A nurse is interviewing a client about the client's usual activity level. The client states, "I swim laps 2 to 3 times a week and walk 1 to 2 miles twice a week. The nurse interprets this activity as which type of exercise?

Isotonic exercise involves muscle shortening and active movement. Examples include carrying out ADLs, independently performing range-of-motion exercises, and swimming, walking, jogging, and bicycling. Isometric exercise involves muscle contraction without shortening (i.e., there is no movement or only a minimal shortening of muscle fibers). Examples include contractions of the quadriceps and gluteal muscles, such as that which occurs when someone holds a yoga pose. Isokinetic exercise involves muscle contractions with resistance. The resistance is provided at a constant rate by an external device that has a capacity for variable resistance. Examples include rehabilitative exercises for knee and elbow injuries and lifting weights. Range-of-motion exercise refers to the maximum degree of movement of which a joint is normally capable.

The nurse is developing a plan of care for a client who has been in the (protective) prone position. What should the nurse be sure to monitor the client for, related to the positioning?

It is important to be aware of client positioning and nursing actions required to prevent complications. The client who is in the prone position is at risk for foot drop (plantar flexion of the feet) because of the pull of gravity on the feet—unless the legs and feet are positioned carefully. The client in the prone position is not at risk for flexion contracture of the neck, because the body is straight—the shoulders, head, and neck are in an erect position. The client would be at risk for flexion contractures of the hips when in the supine or Fowler position. The client in the prone position is lying on his abdomen and therefore would be at risk for skin breakdown of the sacrum. The client in the Fowler position would be at risk for skin breakdown of the sacrum. When in the prone position, the hips are prevented from flexing or hyperextending.

The nurse is teaching a new graduate nurse about the most common causes of back injuries. The nurse knows that the new graduate understands the concepts of back injuries when the graduate states that back injuries:

Many nurses believe that back pain is a routine consequence of the job, but it need not be. Employing principles of body mechanics, use of algorithms, and guidelines for transferring or lifting clients contributes to the prevention of back injuries and pain. Back injuries can occur when uncooperative clients are being repositioned. Back injuries cannot be prevented with the use of a gait belt. Inappropriate use of the gait belt and other factors can contribute to back injuries. Standing, not sitting, for long periods can contribute to back injuries.

The nurse observes an older adult client walks walking with knees slightly flexed and body leaning. What does the nurse identify the client is demonstrating?

Many older people have more difficulty overcoming inertia and using gravity efficiently. One contributing factor is the shift in the center of gravity. To compensate for this shift, the knees flex slightly for support.

A student nurse asks the nurse what trochanter rolls are used for when providing client care. What is the appropriate nursing response?

Trochanter rolls prevent the legs from rotating outward. The other statements do not describe trochanter rolls. Hand rolls preserve the client's functional ability to grasp and pick up objects and help the client avoid contractures. Foot boards prevent foot drop.

The nurse wishes to keep a client from sliding down toward the foot of the bed. Into which position will the nurse place the client?

Placing a client in slight Trendelenburg position may help keep the client from sliding down toward the foot of the bed. Placement into the other position choices does not accomplish the same purpose.

The nurse is caring for a client who is on bed rest and was just turned to the left side. Which action should the nurse take next to decrease the risk of impaired skin integrity?

Positioning the shoulder blade in this manner removes pressure from the bony prominence and thus helps decrease the risk of impaired skin integrity. The other actions should also be performed but do not decrease the risk of impaired skin integrity.

The nurse is providing health teaching for a client who flies often for business. Which risk factor associated with flying will the nurse emphasize?

Prolonged sitting can increase a client's risk for thrombus formation. The nurse will emphasize this and teach stretching exercises. Skeletal contractures, pooling of secretions, and oliguria are not risk factors associated with flying (prolonged sitting).

The nurse is working to increase functional ability with a client. Which assistive technique should be included in the plan of care?

Promoting client independence with movement and activity is an important intervention for clients with musculoskeletal problems. Unlike log rolling and pull sheets, which are nurse-initiated methods, the overhead trapeze is used by the client.

The nurse manager is assessing the unit for proper work ergonomics. Which finding will require immediate intervention by the nurse manager?

Proper ergonomics promote comfort, performance, and health in the workplace. All findings support proper ergonomics, with the exception of equipment positioning. Equipment should be positioned 20 to 30 degrees away, in front, not off to the side, to avoid turning or twisting of the head, neck, and shoulders.

The occupational nurse is teaching an administrative assistant about proper posture when sitting. Which teaching will the nurse include?

Proper sitting posture includes using the buttocks and upper thighs as the base of support, keeping both feet resting on the floor and the knees bent, with the backs of the knees away from the chair to avoid distal circulation concerns. The other choices are unsafe practices.

The nurse is observing an unlicensed assistive personnel (UAP) transferring a client with left-sided weakness from the bed to the chair. What observations made by the nurse require immediate intervention to prevent injury to the client? Select all that apply.

The nurse keeps the client in good body alignment and protects the client from injury while being moved. Safety and comfort are key concerns when assisting a client out of bed. The side rails should be down when transferring a client out of bed. The client should be instructed to use an arm on the arm of the chair for support and stability when getting out of bed. The nurse should stand in front of, not next to, the client as the client sits on the side of the bed; this will prevent falls or injuries from orthostatic hypotension. When assisting the client to sit up on the side of the bed, the nurse should stand near the client's hips. The nurse's center of gravity is placed near the client's greatest weight to assist the client to a sitting position safely. The head of the bed should be elevated to place the client in a sitting position or as high as the client can tolerate. The amount of energy needed to move from a sitting position or elevated position to a sitting position is decreased. Bracing the nurse's knee against the client's weak knee will help prevent it from buckling and the client from falling.

A 59-year old female client reports to the nurse that she recently began taking alendronate and has been having stomach cramping, nausea, and diarrhea. How will the nurse educate the client?

The nurse will educate the client to drink 8 ounces of water when taking the medication and remind the client to take it on an empty stomach. The nurse should not recommend discontinuation or a dosage change. Although some side effects are normal, telling the client to not worry about them does not reflect proper teaching.

Which nursing actions would the nurse perform when assisting clients with passive ROM exercises? Select all that apply

The nurse would adjust the bed to the flat position or as low as the client can tolerate. The nurse would begin ROM exercises at the client's head and move down one side of the body at a time. The nurse would move each joint in a smooth, rhythmic manner. The nurse would not raise the bed to the highest position, but to a position that is waist-high to the nurse. The nurse would not perform each exercise 10 to 15 times, rather 2 to 5 times. The nurse would not use a flat palm, rather a cupping hold to support joints during ROM exercises.

The nurse is preparing a client to be turned in bed. In what position would the nurse place the client to begin this procedure?

The nurse would position the bed so that the client is lying flat on the back and then raise the bed to a comfortable working height. This facilitates moving the client to the side in order to perform the turn in bed. If the client was prone, the client will need to be moved to the client's back. Sitting up is another position a client can be moved into.