Question

A client experienced a stroke affecting the middle cerebral artery and has been bed bound for a few days while being stabilized. The client was finally able to tolerate activities, although arousal is very limited. The client was able to tolerate sitting up with the head of the bed elevated to 40 degrees without a sudden drop in blood pressure. The client's family would like to try to have the client sit up, which will allow him to begin to eat while minimizing the risk for aspiration. Which of the following balance activities should the therapist attempt NEXT?

1) Transfer the client to a chair
2) Elevate the head to 80 degrees
3) Sit the client at edge of bed
4) Attempt to stand by the bed

Answer 1

The therapist should next sit the client at the edge of the bed to engage core muscles and improve balance, with appropriate safety measures to prevent falls.

Step-by-step explanation:

The therapist should attempt to sit the client at the edge of the bed next. This is a more progressive posture than simply elevating the head to 80 degrees and is a prerequisite to more advanced balance activities like transferring to a chair or attempting to stand by the bed. Sitting at the edge of the bed allows the client to engage the core muscles and work on balance, which is required for sitting up to eat and minimizing the risk for aspiration. However, because of the limited arousal and potential for impaired balance following a middle cerebral artery stroke, it will be important to ensure that safety measures are in place to prevent falls or tipping over. The therapist can gradually increase the client's tolerance to sitting up and can assess the readiness for more challenging activities as the client's condition improves.