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Chapter
14

Using medical technology for mobilizing patient.

Grammar practice exercise
Nursing care of immobility patients, identification diagnose.

Mobility Aids
Label the pictures (1-6) below using the words in the box. Which of these mobility aids have you used with
patients ?
commode chair

crutches

walking frame

walking frame with wheels

walking stick

wheelchair

1 ____________________

2 ______________________

3 _____________________

4 ______________________

5 ______________________

6 ______________________

Listening Section 1
Listen the conversation (1-4) between nurses and patients. Complete the table below with some of the
mobility aids in Exercise 1. What are the patients going to do ?
Mobility Aids
The patients is going to
1
2
3
4

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Listening Section 2
Match the following extracts to the conversation (1-4). Listen again and check your answers.
1 2 3 4
Hold the handles for me.
Ill get you the crutches, Mark.
Ill get your walking stick for you
Ill help you into the wheelchair, Gina
Ill help you up now
Just make sure the top of your crutches are a few centimetres
below your armpits.
Make sure the stick is firmly on the ground
Now put your feet on the floor
Now, sit down slowly on the wheelchair
Now, stand up and turn around to face me.
Sit up and swing your legs over the side of the bed
Complete the following strategies for helping a patient to mobilise using the words in the box.
Firmly for me for you Ill imperawtive just make sure name now slowly
Use the Patients (1) _____________ to build rapport.
Use filter words like (2) ____________and (3) _____________ to make instructions less aggressive.
Use the (4) ____________ to tell patients what to do.
Use (5) ____________ to offer help.
Use the words (6) ______________ to tell patients what to check.
Use the phrases (7) ______________ and (8) ______________ to show that you and the patient are both
helping each other.
Use adverbs like (9) ____________ or (10) _____________ to give patients advice about how to do
something.

Getting a patient out of bed.

Label the mobility aids (1-4) below using the words in the box.
hoist

monkey pole

rope ladder

slide sheet

1 _____________________

2 _____________________

3 _____________________

4 ______________________

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Listening Section 3
Sally and Lenka, two ward nurse are discussing patients mobility. Listen to the conversation and complete the following table
with the equipment the patients use.
Patient
Equipment
Mrs. Kovacs
Mrs. Hartley
Ms. Sayed
Mrs. Phillips
Listen again and complete the following extracts from the conversation using the words in the box.
lift up

move

put

sit up

turn

use

She uses the rope ladder to help her (1) ______________ in bed.
Youll need the slide sheet to (2) ______________ her in bed.
Can Ms. Sayed (3) _______________ her bottom for a bedpan ?
I (4) ___________ a monkey pole on the bed for her.
You have to (5) _____________ the hoist. She cant (6) _____________ much at all now.

Listening Section 4
Caroline, the ward nurse is helping Mrs. Kennedy a patient who recently had a hip operation, get out of bed. Listen to the
conversation and answer the following questions.
1. Why is Mrs Kennedy getting out of bed ? ................................................................................................................
2. What does Mrs Kennedy use to help her walk ?......................................................................................................
3. What does Mrs Kennedy hold to make her steady ?...............................................................................................
Complete the following extracts from the conversation using the words in teh box. Listen again and check
your answers.
both hands
put
walk

feet
floor get up handles
hold x2
rope ladder
shower x2
sie of the bed
walking frame

leg
sitting

pull up
swing

Im going to help you (1) ___________ for yor (2) ____________ now.
OK, (3) ______________ the (4) ____________ with both hands.
Now, (5) _____________so you are (6) ________________.
Now, (7) _____________ your (8) ____________ over the (9) ______________ slowly.
Thats right, (10) _________________ your (11) ______________ firmly on the (12) _____________
Now, (13) ____________ the (14) ___________ of the (15) ___________ with (16) _____________
OK, youre ready to (17) ____________ to the (18) _______________now.

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Using a slide sheet.

Look at the picture of two nurses using a slide sheet to move a patient and label the pictures (1-6) below
using the verbs in the box.
lift

pull

roll x2

take out

tuck

Listening Section 5
Julia and Su, two ward nurses are using a slide sheet to move Mrs McKenzie, a patient. Listen to the
conversation and put the following extracts in the correct order.

Ill take out the slide sheet now.

First, roll over on your left side
Now, roll over again on your life side
Ill just pull the slide sheet through to my side
Were just going to tuck the slide sheet under you, Mrs McKenzie
Now, roll over on the other side
Sus going to tuck in the slide sheet
One, two, three-lift.
Ill lift up the head of the bed so you can eat your lunch
Julia and I are going to help move you up the bed

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Medical technology for mobilising patients.

A. Look at the picture (above) and answer the following questions.

1. Where is the patient?
2. Why might they be moving the patient?
3. How are they moving the patient?
B. Read the notes about AirSlide and answer the following questions.
1. Do you have to remove the mattress when you have moved the patient? ....................................................
2. What do you have to do before you wash the mattress? ..................................................................................
3. What is the AirSlide made from? .........................................................................................................................
4. Do you need to wash the cover sheet every time you use it? ..........................................................................
5. Do you need to remove the mattress before the patient has an X-ray? .........................................................
6. Where should you keep the mattress when youre not using it? .....................................................................
7. Why is there no Velcro on the mattress? ............................................................................................................

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C. Complete the following statements 17. Use the words in the box below.
radiology
1.
2.
3.
4.
5.
6.
7.

obese

air-filled

move

wheeled

remain

thrown

The AirSlide is a special _____________ mattress.

The AirSlide helps hospital staff _____________ patients easily.
Patients _____________ on the mattress at all times.
The AirSlide may be used during _____________ procedures.
It is suitable for very large or ______________ patients.
The mattress can be ________________ around in its trolley bag.
The cover sheet of the mattress can be ______________ away if it gets dirty to

Grammar Practice
A. Look at these sentences that a nurse, a patient or a hospital visitor might say.
Complete the sentences using the words in the box. Use each word twice.
as

because of

for

so

to

1.
2.
3.
4.
5.
6.
7.
8.
9.

Make sure the stick is firmly on the ground ___________ you dont want to fall.
Do you use the walking frame __________ help you?
Im afraid I cant give you any information ____________ patient confidentiality.
Hold the handles for me __________ you dont fall over.
I cant visit my sister _____________ the stairs she lives on the third floor and theres no lift.
Would you like to go outside __________ a short walk?
Youll need the slide sheet ____________ turn her in bed.
Im going to take you to the bathroom now __________ a bath.
Make sure the top of your crutches are a few centimetres below your armpits, ___________ they can
hurt a lot if they crutches press into your armpits.
10.Were just going to tuck the slide sheet under you ___________ we can lift you up the bed.
B. Look at the sentences (aj) in the box that a nurse or patient might say.
Complete the second part of the dialogues below with a sentence (aj).
a
b
c
d
e
f
g
h
i
j

Oh dear. Ill get you another blanket if you like.

I dont know, Mr Cho, but Ill ask the doctor if you like.
Hmmm I wont wake her up. Ill tell him to call back later.
Oh, sorry. Ill switch it off.
Yes of course Ill just get her extension number.
Yes and then shell have an appointment with Doctor Hansford.
OK, so we wont make you walk too far today.
I promise well be very gentle, Mr Brown.
OK, Helen, Ill change it for him.
Dont worry. Ill pass it to you.

1. A: Sue, Mr Gimlets IV is going to finish in half an hour, but I need to go to the OT now.
B: ___________________________________________________
2. A: Can you help me, Rachel? Im afraid Ive dropped my walking stick.
B: ___________________________________________________
3. A: Please dont be rough when you lift me up.
B: ___________________________________________________
4. A: Im afraid you cant use your mobile phone in this ward, Mrs Miller.
B: ___________________________________________________
5. A: Ive got Mrs Bookers husband on the phone, but shes still asleep.

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B: ___________________________________________________
6. A: Im feeling a bit cold, Bob.
B: ___________________________________________________
7. A: Im sorry, Louise. Im feeling very weak after my operation.
B: ___________________________________________________
8. A: Sorry, Mike. What time will I be able to go home?
B: ___________________________________________________
9. A: Will Mrs Mann have the injections for six months?
B: ___________________________________________________
10.A: Hi, Its Andy Lau here. Id like to speak to my wife please Melody Lau.
B: ___________________________________________________
C. Look at these sentences that a nurse might say. Rewrite each sentence following
the instruction in brackets and underline the verb phrase.
1. The injection will hurt.
positive > negative
__________________________________________________
2. Were going to be able to lift Mr Howard without a sling.
positive > negative
__________________________________________________
3. Mr Thomson probably wont need his wheelchair for another six months.
negative > positive
__________________________________________________
4. You wont feel better in a few days.
negative > positive
__________________________________________________
5. I probably wont pass the exam tomorrow because I havent had time to study.
negative > positive
__________________________________________________
6. Am I going to need a patslide to transfer Ms Slessor to the trolley?
question > positive
__________________________________________________
7. Will Mr Milligan need vitamin B12 injections every two months?
question > negative
__________________________________________________
8. Mr Adams is going to have his operation today
positive > question
__________________________________________________
9. Mrs Spencerll be able to use the crutches.
positive > question
__________________________________________________
10.Your Dad is going to visit you this afternoon, Julia.
positive > question
__________________________________________________

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Case 1
Read the paragraph and answer the following questions.
Robert Brown is a 72-year-old man who is admitted to the rehab unit following an open reduction
internal fixation (or ORIF) of the left hip to repair an intertrochanteric fracture. The fracture was sustained
when he tripped over his dog and fell. Mr. Brown is married and is an active, independent senior. He spent
a week in ICU following the procedure due to a mild CVA, which delayed his initiating physical therapy.
Prior to the hip fracture he was being treated for HTN, CAD and arthritis. His recent CVA has left him
with some residual left-arm weakness. Mr. Brown is being transferred to the inpatient rehabilitation unit to
start aggressive physical therapy for the CVA and post-surgical hip repair.
The nurse admitting Mr. Brown performs a complete assessment and reviews his hospital record.
She makes note of his medical history and current medications. These medications include: Coumadin 5
mg qd, Lisinopril 20 mg qd, Crestor 5 mg qd, Tylenol Arthritis 650 mg (2 tabs bid) and hydrocodone
5/500 q6h prn pain. The surgical incision is clean and well-approximated. She initiates lab orders for a
PT/INR and notifies the therapy department of his arrival.
1. Based on Mr. Browns history and understanding the possible complications of immobility, the nurse
should initiate what preventive measure(s)?
A. Provide adequate hydration
B. Use a safety belt on Mr. Browns wheelchair
C. Apply anti-embolism hose
D. Provide supplemental protein shakes between meals
2. Mr. Browns INR is done to monitor his Coumadin dosing and the results indicate that his INR is 4.5.
The nurse notifies the MD, who discontinues the Coumadin and starts Plavix 75 mg qd after 48 hours.
Based on the complications of immobility, the action of Coumadin, and Mr. Browns history, the nurse
understands that :
A. Mr. Brown is at higher risk for emboli due to surgery and immobility.
B. The decreased plasma and blood volume that occurs with immobility may have contributed to the
increased INR.
C. Ventricular volume is decreased, leading to venous pressure changes and stasis
D. All of the above
3. Physical and occupational therapists have completed their initial evaluation of Mr. Brown and have
determined a plan of treatment to include seven days a week of ambulation and gait training, left arm
strengthening and ROM. The nurse should be aware that which one of the following problems might
occur due to Mr. Browns length of immobility?
A. Possible fracture of the left radius during ROM due to bone demineralization
B. Increase in blood pressure due to exertion of exercise program
C. Orthostatic drop in blood pressure when standing with risk for syncope and falls
D. Need for supplemental oxygen during ambulation
4. On Mr. Browns third day on the rehab unit, the nurse notes that he is more lethargic, confused and has
a low-grade fever. When questioned, he reports that he is having some minor chest pain and occasional
difficulty catching his breath. A review of his flow sheets for the last 24 hours shows that he has had
increased urination, occasional tachycardia and a decreased BP. The nurse should suspect which of the
following?
A. Fat embolism
C. Urinary tract infection
B. Pneumonia
D. All of the above

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Answer and Question

1. What is meant by "concentric tension" of muscles?
A. Increased muscle contraction results in movement.
B. The speed and direction of movement are controlled.
C. Tension causes no shortening or active movement.
D. Tension does not result in isotonic contraction.
2. Joints are the connections between bones. The joint that is freely movable is known as the _____ joint.
A. Synostotic
C. Fibrous
B. Cartilaginous
D. Synovial
3. The term body alignment refers to positioning of the joints, tendons, ligaments, and muscles while
standing, sitting, and lying. A term that is similar to body alignment is
A. Weight.
C. Friction.
B. Posture.
D. Body mechanics.
4. Patients on bed rest or otherwise immobile are at risk for
A. Increased metabolic rate.
C. Altered metabolic function.
B. Increased diarrhea (peristalsis).
D. Increased appetite.
5. In caring for a patient who is immobile, it is important for the nurse to understand that
A. The effects of immobility are the same for everyone.
B. Immobility helps maintain sleep-wake patterns.
C. Changes in role and self-concept may lead to depression.
D. Immobile patients are often eager to help in their own care.
6. Immobility is a major risk factor for pressure ulcers. In caring for the patient who is immobilized, the
nurse needs to be aware that :
A. Breaks in skin integrity are easy to heal.
B. Preventing a pressure ulcer is more expensive than treating one.
C. Immobilized patients can develop skin breakdown within 3 hours.
D. Pressure ulcers are caused by a sudden influx of oxygen to the tissue
7. The nurse is evaluating the body alignment of a patient in the sitting position. In this position
A. The body weight is directly on the buttocks only.
B. Both feet are supported on the floor with ankles flexed.
C. The edge of the seat is in contact with the popliteal space.
D. The arms hang comfortably at the sides.
8. When assessing the skin of an immobilized patient, the nurse should
A. Assess the skin at least every 4 hours.
B. Use a standardized tool such as the Braden Scale.
C. Use nursing instinct instead of a standardized tool.
D. Have special times for inspection so as to not interrupt routine care.
9. The patient who is experiencing an alteration in mobility often has one or more nursing diagnoses. The
nurse would use the diagnosis of Impaired physical mobility for a patient who is
A. Not completely immobile.
B. Completely immobile.
C. At risk for multisystem problems.
D. At risk for single-system involvement.
10.In preparing to create a nursing diagnosis for a patient who is immobile, it is important for the nurse to
understand that :
A. Physiological issues should be the major focus.
B. Psychosocial issues should be the major focus.
C. Developmental issues should be the major focus.
D. All dimensions are important to health.