[0:07]Hey guys, what's up? It's me, Ira, your student nurse on duty from BSN 13D Group 15.
[0:14]So, for today's video, we are going to return demonstrate the assisting in ambulation without aid.
[0:23]So, number one, we are going to review patient's record on the most recent activities and then record patient's weight.
[0:33]By doing so, we will be able to evaluate and assess patient's current status.
[0:43]Medical record of the patient shows the patient was able to tolerate recent activity.
[0:49]The current weight of the patient is around 46 kg.
[0:54]Number two is to review patients record on medical history or risk for orthostatic hypertension.
[1:03]In that way, we are able to identify patient's limitations during ambulation for patient safety.
[1:12]Medical history of patient shows right-sided weakness with no signs of hypertension.
[1:20]Number three is to review health care provider's order for activity, note mobility or weight bearing restrictions.
[1:27]In that way, we will be able to identify and review the doctor's order and also as health care providers, we will be able to identify or evaluate other special considerations when doing the activity or procedure or in assisting the ambulation.
[1:47]The patient chart shows doctor's order to ambulate patient once a day, preferably in the morning.
[1:57]Um, the patient can move both her lower extremities in consideration with um her weak side, which is the right lower leg.
[2:10]Number four is to determine patient's best time to ambulate in order to maximize patient's energy during the ambulation.
[2:20]And also, to give patient's ample time to rest for future activities.
[2:28]According to the doctor's order, the best time to ambulate the patient is after she had her breakfast, so that she has more energy to move and enough time to rest for other activities.
[2:40]Number five is to identify patient's environment for any barriers or any signs of safety risk.
[2:48]In that way, we will be able to protect not only the patients, but also the health care providers during the execution of any procedures.
[2:59]The patient's environment has no barrier or any safety risk, so it is now safe to continue with ambulation.
[3:08]Number six is to identify patient's identity by using at least two identifiers.
[3:15]It could be first, the patient's name and second, the patient's birth date.
[3:20]In that way, we will be able to ensure that we are doing the right procedure to the right patient.
[3:34]Good morning, ma'am. Pwede ko mongutan, ma'am, sa imuhang pangalan o birth date?
[3:39]Abigail Joan Galam po. Ang birth date, ma'am? August 28, 1999.
[3:45]Mangita ako sa wristband, ma'am, ha? Salamat, ma'am.
[3:50]Number seven is to do hand hygiene. This is done to stop the spread of microorganisms during any procedures.
[4:09]Number eight is to assess patient's readiness to ambulate.
[4:13]So first, we should assess patient's baseline vital signs, such as the blood pressure, the heart rate, the respiratory rate and the temperature for our baseline data and to note for any changes before and after the ambulation.
[5:16]Hello, ma'am. Kumusta? Ma'am, malihog ba nato ang left leg nato, ma'am?
[5:19]Ang left leg nato, ma'am? Saka daw palihog, ma'am. Kaning ang right leg nato, ma'am?
[5:27]Hmm, medyo hinay, no? Kaning atong tiil, ma'am. Ang left leg, ma'am, tikang na nato. Kaning right leg, ma'am. Hmm.
[6:04]Medyo muwiya, diri, ma'am. Sige, ma'am, salamat, ma'am, ha?
[6:08]Number nine is to assess patient's range of motion and strength when in bed, if necessary.
[6:14]This allows you to assess and evaluate patient's capability and limitations for the procedure or any future activities.
[6:24]And also, you will be able to identify and assess patient's weak side.
[7:12]Ma'am, kumusta, ma'am? Okay lang. Wala ba ka gibati og kakapoy? Wala, ma'am. Ang imohang tiil, ma'am, diri banda sa imohang paa. Dili man nagasakit, wala sakit? Wala, po.
[7:25]Mm, ma'am, naa koy mga isugo sa imoha, ma'am. Okay lang ba, ma'am, para sa atuang procedure karon? Okay lang.
[7:31]Kaning okay lang ba si muha, kung kantara ka ng pabangonon taka, palaklakon tika ginagmay? Okay lang ba? Okay lang. Number 10 is to ask if the patient feels tired or if there is pain present.
[6:37]So, note for the source of pain, the characteristic of pain, the level of pain or the severity of pain by using a pain scale from 1 to 10.
[6:46]One being the lowest and 10 being the highest.
[6:51]So, the pain scale is interpreted as 1 to 3 being mild, 4 to 7 moderate, then 8 to 10 being the severe.
[7:00]So, as for the doctor's order, you can administer an analgesic as needed to relieve the patient's feeling of pain to alleviate and to promote comfort.
[7:58]Ma'am, wala man ta'y problema sa pandongog, ma'am, no? Makadungog man ta tarong? Oo.
[8:03]Kay kailangan man gyud na siya, ma'am, pag karon muhi-mutang procedure, ka na mag-instruct sa imoha, maghatag ko sa imoha og ka ng instruction.
[8:10]Mas maayo man gud pag makadungog kag tarong para mas masabtan nimo ang atong instruction para direcho-direcho ang atong procedure. Dili na pud ka mahago, ba. Sige. Number 11 is to assess patient's level of response to command and views regarding health.
[7:49]This is to identify and to assess patient's level of cooperation and willingness during the procedure.
[8:46]Elevate the head of the bed and then lower the bed's position.
[8:51]And then, we are going to place a socks into the patient's feet.
[8:58]Ma'am, magsuot ta'y medjas, ma'am, ha?
[9:02]Isaka nato ang tiil, ma'am, ha? Pikas, ma'am.
[9:14]After placing a socks into the patient's feet, we are going to place a non-skid shoes.
[9:21]Ma'am, magsuot ta'g shoes, ma'am, ha?
[9:28]Pikas, ma'am.
[9:38]Number 13 is to place a chair or a wheelchair nearby the patient.
[9:44]This is done if ambulation is not or cannot be tolerated by the patient.
[9:52]Ma'am, i-sidewview ka, ma'am, ha? I-atubang tika diri, ma'am. Dali lang, ma'am, ha? Atong i-ane imong tiil, ma'am.
[9:59]Tapos i-cross nato imuhang lawas, ma'am. Mang-count ko og 1-2-3, ma'am, ha? 1-2-3, go.
[10:05]Number 14 is to explain to the patient how to prepare for the procedure.
[10:10]Also, explain to them the benefits of the procedure or the ambulation.
[10:15]This act increases their feeling of involvement during the planning and implementation of the set care plan.
[10:24]Educating the patient about the procedure that will be done or the care of plan that was set for them will increase trust and cooperate, elicit cooperation.
[10:40]Number 15 is to assist the patient from a supine position to the side of the bed.
[10:47]Ma'am, i-sidewview ka, ma'am, ha? I-atubang tika diri, ma'am. Dali lang, ma'am, ha? Atong i-ane imong tiil, ma'am.
[10:54]Tapos i-cross nato imuhang lawas, ma'am. Mang-count ko og 1-2-3, ma'am, ha? 1-2-3, go.
[11:01]Number 16 is to elevate the head of the bed and then lower the bed position.
[11:06]Also, place a socks into the patient's feet and a non-skid shoes to promote safety and prevent injury during the ambulation.
[13:43]Next is to place one of your hands under the patient's shoulder and the other hand into the patient, under the patient's thighs.
[13:52]This promotes support to the patients during the movement from supine to a sitting position.
[14:22]Ma'am, mag-slide ta, ma'am, ha.
[14:30]Ma'am, mang-count ko og 1-2-3, ma'am, ha? I-lingkod tika, ma'am, ha? Sige. 1-2-3.
[14:43]Next is to allow patient to rest for a couple of minutes from a sudden change of position from a supine position to an upright position.
[14:51]Also, encourage patient to move their legs, flex their legs and extend their legs up and down for a good blood circulation.
[15:00]You can also check for blood pressure if necessary.
[15:03]Assess and evaluate patient's feeling of dizziness at the moment.
[15:10]Facilitate a set of breathing exercises, inhale and exhale to provide patient ample time to rest, to maximize patient's energy for the next step for the procedure.
[15:25]Ma'am, wala ka gibati kalipong, ma'am? Wala man.
[15:28]Ma'am, atong i-hingi atong mga tiil, ma'am. Atong hingaan, ma'am. Pahulay sa ta, ka gyud, ma'am, ha? Dili ta mabati kalipong o kakapoy? Sige.
[15:38]Next is to place a gait belt towards the patient's waist.
[15:42]Also, ensure that you are holding the gait belt securely.
[15:45]The gait belt will serve as a support to patient during the movement.
[15:51]Ensure that you are placing the gait belt above the clothing of the patient to avoid discomfort and pain towards the patient.
[16:02]And also, ensure that during the placing or the placement of the gait belt, you are assessing and evaluating the um the level of comfort of the patient if the gait belt is too loose or too tight to the patient's waist.
[16:21]Ma'am, magsuot ta og gait belt, ma'am, ha? Kaning tabangan ka ani nga support pag tindog nato unya. Ma'am, magsuot ta og gait belt, ma'am, ha? Kaning tabangan ka ani nga support pag tindog nato unya.
[16:43]Next is to prepare patient for a standing position by placing your hands at the waist of the patient for support.
[16:50]And the patient's hand at your back.
[16:53]So, it is very important that you should have a good communication with the patient during the movement.
[17:00]For example, you should instruct patient that at the count of three, you will start the change of movement from a sitting position to a standing position.
[17:07]This also allows the assessment and evaluation of patient's capability to ambulate.
[17:18]Ma'am, karon, ma'am, kaning i-assist tika magtindog ta, ma'am, ha?
[17:21]So, ibutang nako ang akong kamot sa imohang hawak, tapos ibutang nimo ang imong kamot sa akong likod.
[17:26]Tapos, i-assist tika, i-support tika pagtindog, ha?
[17:29]Sige. Anna, ma'am, ha? Mang-count ko og three, ma'am. Sige. 1-2-3, go!
[17:38]Next is to return the patient immediately to the bed or to the chair if necessary, or if there is a feeling of unsteadiness or a moment of imbalance.
[17:49]You can also ask for help or assistance if the situation caused you to.
[17:54]So, this is done to prevent and avoid injury to the patient and also to promote safety not just for the patient, but for you as the health care provider.
[18:09]Next is to place an IV pole at the side of the infusion.
[18:12]It is done to provide an additional support to patient during the walking.
[18:20]So, instruct patient to push the IV pole during the walking to promote safety to the patient and avoid further injury.
[18:32]Ma'am, naay IV stand, ma'am, ha? So, kani, makatabang ni pag-habang galakaw ka.
[18:37]Mao gihapon, siya ang mag-support sa imoha habang ga-tikang.
[18:40]So, ato ni siyang haweran, ma'am. Tapos, habang ga-tikang ta'g usa, ma'am, usa, tapos kani siya, ma'am, ato ni siyang itulak.
[18:46]Pusika na pud. Hinay-hinay lang ta'g tikang, ma'am, para dili ka makabati og kalipong.
[18:50]Nga kung kakapoyon gani, ma'am, hunong lang ta, ma'am, ha? Sige.
[18:55]1-2-3, go. Tikang. Tikang, hunong. Tikang.
[19:05]Next is to empty bag appropriately and ensure proper handling of patient's tubing to avoid tension of the tubing.
[19:15]And also, to promote uh easy movement and avoid interruptions during the ambulation.
[19:24]Next is to decide with the patient how far to walk during the ambulation.
[19:29]It is done not only to promote safety to the patient, but also in consideration with the patient's feelings and to encourage patients to express their feelings during that moment of doing or executing the procedure or the ambulation.
[19:50]And also, it assesses or it allows um us as health care providers to assess patient's limitation for that certain uh procedure.
[20:08]Kamusta man, ma'am? Gibati kag kakapoy, hangak ba? Wala man.
[20:11]Okay lang simuha mo padayon ta or diri lang ta kutob sa atoang paglakaw-lakaw? Okay pa man ko, padayon ta'g lakaw-lakaw.
[20:18]Sige, ma'am. Tikang, hunong. Tikang, hunong.
[20:25]Next is to stand appropriately on the weak side of the patient to, of course, provide an additional support to patient during the ambulation and, of course, promote patient safety.
[20:37]Ensure that your position as health care providers should not block the patient's um way or path of ambulation.
[20:50]Next is to hold patient's gait belt properly and appropriately.
[20:55]And also, ensure that you are grasping patient's gait belt securely to provide a quality support to patient during the ambulation or during their few steps.
[21:06]And also, of course, to promote comfort to patient throughout the procedure.
[22:08]Next is to observe patient while walking or during the ambulation.
[22:12]This allows you to track patient's progress or to evaluate the current status of the patient or patient's tolerance of the procedure.
[22:24]Next is to be alert if the patient shows any signs of fall during the ambulation or during any procedure.
[22:33]This is the main reason why health care providers should ensure to hold the gait belt securely and appropriately to promote and provide a quality support to patient while walking or during any procedure.
[22:51]Next is to widen your feet at the back of the patient to strengthen the base and to maintain the center of gravity or the center balance to promote and provide support to patient.
