The nurse is planning care for a client who is newly wheelchair bound owing to a spinal cord injury. What priority intervention should the nurse include in the plan of care to assist the client in transferring from the bed to the wheelchair?
a. A diet high in protein and low in calories
b. An occupational therapy consult
c. Bowel and bladder retraining
d. Upper arm strengthening exercises
D
With impaired mobility and use of a wheelchair, the client tends to gain weight. During rehabili-tation, the client should be on a high-protein diet but not calorie restriction. The increased weight requires greater upper body strength for movement. The nurse should encourage the client to perform exercises that strengthen the upper arms. The nurse should consult physical therapy to assist with these exercises. Occupational therapy would not be involved in movement of the client but would be involved with ADLs. Bowel and bladder retraining may prevent skin break-down but has nothing to do with the client's ability to transfer to the wheelchair.
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