On which side should a CHO/nurse stand to assist a stroke patient?

Appeared in: UP CHO - 2018

Explanation

The correct and safest position for a nurse assisting a patient with unilateral weakness (like after a stroke) is on the patient's weak or affected side.
This positioning allows the nurse to provide direct support to the patient's trunk and weak leg, which are most at risk for giving way.
By standing on the weak side, the nurse can effectively counteract the patient's tendency to lean or fall toward the side with less muscle control.
Using a gait belt while standing on the weak side provides a secure point of contact to stabilize the patient and guide their movement safely.

Option B: Standing on the strong side leaves the weak, unstable side completely unprotected. The patient relies on their strong side for their own support and stability.
Option C: Standing directly behind the patient does not provide adequate support for a sideways fall, which is the primary risk. It also makes it difficult to assist the patient's weak leg.
Option D: This is synonymous with 'From behind' and is incorrect for the same reasons. It does not allow for effective stabilization of the patient's weak side.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient safety and mobility assistance for stroke patients with unilateral weakness to guide bedside assessment, documentation, and the next nursing action.
Patient safety is the highest priority during mobilization. Incorrect positioning can lead to falls and serious injury for both the patient and the nurse.
A thorough assessment of the patient's motor strength, balance, and cognitive function is essential before attempting to ambulate.
Always use a gait belt for patients who are weak or have balance issues. It provides a secure handle for the nurse and reduces the risk of injury.

How to Approach the Question

Identify the core of the question: It asks for the safest position to assist a patient with one-sided weakness.
Recall the principle of support: You must support the part of the body that is weakest and most likely to fail.
For a stroke patient, the weakness is on the affected side. This is where they are most likely to lose balance and fall.
Therefore, the helper must position themselves on the weak side to provide a 'human crutch' and prevent a fall.
Eliminate other options: The strong side is used by the patient for support. Standing behind offers no protection from a sideways fall.

Concept Tested & Keywords

Concept Tested: Patient safety and mobility assistance for stroke patients with unilateral weakness.
Stem keywords: stroke patient, assist, nurse, stand
Lead-in keywords: On which side

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E6 Nursing Fundamentals Taylor p. 340-342

E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 115-117

Practise the full UP CHO - 2018

Attempt every question from this paper in a timed mock, then review the full solution for each one.