The nurse instructs the patient, who has right-sided weakness, to use the cane during ambulation and assesses the patient's use of the cane. Which assessment should the nurse address before the patient ambulates with the cane?
a. The cane makes a tapping sound each time the patient touches it to the floor.
b. The patient holds the cane in the unaf-fected hand for support.
c. The patient holds the cane 10 to 15 cm (4 to 6 inches) to the side of the left foot.
d. The patient ambulated 4 times with the cane in physical therapy.
A
The cane should have a rubber tip on the end and should be silent when the rubber tip contacts the floor, indicating that the rubber is intact; if the cane clicks each time it hits the floor, the rub-ber cannot effectively maintain the patient's stability. Using the cane on the unaffected side is proper technique for ambulating with a cane. Holding the cane 10 to 15 cm (4 to 6 inches) to the side of the unaffected foot is appropriate. The patient's history of cane use is valuable informa-tion for subsequent instruction and gives the nurse a basis for comparison.
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