Question

the nurse is assisting with client transfer. which guideline(s) will the nurse consider prior to helping the client move from the bed to a chair? select all that apply.

make sure the clients weaker leg is nearest to the chair.
provide step-by-step instructions to the client before the transfer begins.
ensure that the clients bedrails are up prior to transfer.
provide the client with nonskid slippers to put on prior to standing up.
lower the bed to the lowest position allowing the clients soles to contact the floor.

Explanation:

Analyze the transfer mechanics

Using the Patient Transfer Guidelines knowledge point, we evaluate the optimal positioning of the chair relative to the client's physical deficits. When transferring a client with unilateral weakness (hemiparesis) from a bed to a chair, the chair should be positioned on the client's stronger side. This allows the client to pivot on their stronger leg and use their stronger arm to reach for the chair, maximizing stability. Therefore, placing the weaker leg nearest to the chair is incorrect and unsafe.

Assess communication and preparation

Using the Patient Ambulation Safety knowledge point, preparing the client cognitively is essential for a coordinated movement. Providing clear, step-by-step instructions before the transfer begins ensures that the client understands their role, reduces anxiety, and prevents sudden, uncoordinated movements that could lead to falls.

Evaluate environmental safety barriers

Using the Patient Transfer Guidelines knowledge point, we assess the role of bedrails during active egress. Keeping the bedrails up during the transfer would physically block the client from pivoting and exiting the bed safely. Bedrails must be lowered on the side of the transfer to allow unobstructed movement.

Evaluate footwear and surface contact

Using the Patient Ambulation Safety knowledge point, preventing slips is a primary safety intervention. Providing nonskid slippers or shoes prior to standing prevents slipping on smooth hospital floors. Additionally, lowering the bed so that the client's feet are flat on the floor provides a stable base of support and leverage before they attempt to stand.

Answer:

• Make sure the client's weaker leg is nearest to the chair.
• Provide step-by-step instructions to the client before the transfer begins. (Correct answer)
• Ensure that the client's bedrails are up prior to transfer.
• Provide the client with nonskid slippers to put on prior to standing up. (Correct answer)
• Lower the bed to the lowest position allowing the client's soles to contact the floor. (Correct answer)