The client is visually impaired and the nurse delegates client ambulation to the nursing assistant. Which instruction for the client does the nurse provide to the nursing assistant? (Select all that apply.)

Question

1. Hold the nursing assistant's arm.
2. Walk directly behind the client.
3. Speak directly in front of the client.
4. Hold the client's nondominant hand.
5. Stand on the client's nondominant side.
6. Rest hands on nursing assistant's shoulders.

Answer 1

1, 5
1. The nurse instructs the nursing assistant to have the client hold onto the nursing assistant's arm during client ambulation because the nursing assistant is providing guidance for the visually impaired client. The client is able to ambulate physically and needs assistance to avoid environmental hazards.
5. The nurse also instructs the assistant to stand on the client's nondominant side, al-lowing the client full use of the dominant side for stability.
2 and 4. The client is able to ambulate, so walking behind the client and holding the client's nondominant hand are unnecessary; in addition, the position behind the client can impair the assistant's ability to foresee and avoid hazards.
3. The client has a visual impairment and not a hearing impairment.
6. Walking behind the nursing assistant with both hands on the assistant's shoulders is unnecessary because the client is able to ambulate and needs simple guidance around hazards.