The nurse reviews the diagnoses for assigned clients. Which client has the greatest potential for injury during transfers?

Question

1. Deep vein thrombosis
2. Type 1 diabetes mellitus
3. Upper extremity fracture
4. Cerebrovascular accident

Answer 1

4
4. The client who has a cerebrovascular accident (CVA) has the greatest potential for injury during a transfer because most CVAs result in a neurological deficit. The defi-cit can involve communication, sensory, and muscle function, decreasing the client's ability to interact with the environment, assist with movement, and, thus, increase the risk for injury.
1. Although the client with a deep vein thrombosis usually does not have impaired neurological or muscle functioning, the client usually does receive anticoagulation; if the client is injured during a transfer, the risk for significant bleeding increases. These clients usually retain the ability to interact with the environment unless a comorbidity interferes.
2. Clients with type 1 diabetes mellitus have a risk for injury due to decreased sensa-tion in the extremities caused by microvascular complications of hyperglycemia. The clients usually retain the ability to interact with the environment to minimize the risk for injury during a transfer.
3. The client with an upper extremity fracture can have significant pain, and the treatment for pain increases the client's risk of injury during a transfer because of dizziness, decreased level of consciousness, and hypotension. This client is also less stable with one nonfunctional arm and can have difficulty assisting with transfers us-ing the other arm.