When helping a stroke patient nurse should assist

Appeared in: JIPMER Nursing Officer-2017

Explanation

The primary principle of assisting a patient with unilateral weakness is to guard the affected side to prevent falls.
Stroke often causes hemiparesis or hemiplegia, making the patient unstable and prone to falling toward their weaker side.
By positioning themselves on the weak side, the nurse can provide optimal support to the patient's trunk and pelvis if they lose balance.
This position allows the nurse to anticipate and react to instability, effectively bracing the patient and preventing injury.

Option B: Assisting on the strong side leaves the weak, unstable side unguarded and vulnerable to collapse, significantly increasing the risk of a fall.
Option C: Assisting from directly behind does not provide adequate lateral (side-to-side) support, which is the most common type of instability for a patient with hemiparesis.
Option D: This is synonymous with 'From behind' and is incorrect for the same reason: it fails to provide the necessary lateral support to prevent a fall to the weak side.

Clinical Relevance

Nursing practice connection: Use the key finding related to Safe patient handling and mobility assistance for a patient post-stroke to guide bedside assessment, documentation, and the next nursing action.
Correct positioning during mobilization is a critical patient safety competency for nurses, directly preventing falls and subsequent injuries like fractures or head trauma.
Using proper technique, including a gait belt and correct positioning, also protects the nurse from musculoskeletal injuries.
What if? If the patient is transferring from a bed to a wheelchair, the nurse should place the wheelchair on the patient's strong side. This allows the patient to bear weight on their stronger leg and use their stronger arm to pivot safely into the chair.

How to Approach the Question

First, identify the question type. This is a clinical procedure and safety question.
Recall the key pathophysiology of a stroke: it often results in unilateral weakness (hemiparesis).
The core principle of assistance is to protect the patient from injury. This means supporting their weakest point.
Analyze the options in terms of safety. Positioning on the weak side provides a direct brace against the most likely direction of a fall.
Eliminate other options. Assisting on the strong side leaves the weak side vulnerable. Assisting from behind does not provide lateral stability.
Therefore, the safest and most appropriate position is on the patient's weak side.

Concept Tested & Keywords

Concept Tested: Safe patient handling and mobility assistance for a patient post-stroke.
Stem keywords: stroke patient, nurse, assist
Lead-in keywords: should assist
Clinical cues: The diagnosis of 'stroke' implies a high risk of unilateral weakness (hemiparesis), which dictates safety protocols for mobility.

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 61-63

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

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