Confused on Canes! Help, please?

[RNsRWe, ASN, RN]

I thought I had this down cold, but something's not gelling: to walk with a cane, keep the cane on the STRONG side. Step with the cane and affected leg together, followed by good leg. Ok.

Stairs: I remembered the phrase "up with the good, down with the bad" and all the other forms of it :). I know to lead with the BAD leg when going downstairs, good leg when going up. So when I got a practice question that told me to determine if a client was doing it correctly when walking downstairs, I didn't think I'd get it wrong, but it said I did!

According to the rationale, the guy is supposed to put NOT the "bad leg first" going down the stairs, but the CANE first, THEN the bad leg, followed by the good leg. YET, when going UP the stairs it's the GOOD LEG first, THEN the cane...??? Do I have this right now?

The Kaplan video breezed over it, and the one line in the book said to go up stairs with good first, then cane, then bad, and REVERSE it to go downstairs (but you're really not reversing).

Help me get this through my head? Is this right now?

[stressgal, RN]

Yep you do. I was taught to remember the good goes up and the bad goes down.

[RNsRWe, ASN, RN]

Yep you do. I was taught to remember the good goes up and the bad goes down.

I remembered that, too, but that's why I got it WRONG: in going downstairs, it isn't the bad leg that goes first, it's the CANE that goes first, THEN the bad leg, then the good.

I think...

[pri4fun]

I was listening to some of the questions on the kaplan video ( Basic Care and Comfort section) and came across this question (no: 5) about going up the stairs with a cane.

In that she clearly says WHILE GOING UP STAIRS YOU ADVANCE THE GOOD LEG FIRST --- THEN THE CANE ---- THEN THE WEAK LEG.

and as far as going down the stairs just like you said , and like the question in qbank its just the opposite DOWN WITH BAD--- THEN CANE--- THEN GOOD LEG...

hope this helps ...

[RNsRWe, ASN, RN]

I was listening to some of the questions on the kaplan video ( Basic Care and Comfort section) and came across this question (no: 5) about going up the stairs with a cane.

In that she clearly says WHILE GOING UP STAIRS YOU ADVANCE THE GOOD LEG FIRST --- THEN THE CANE ---- THEN THE WEAK LEG.

and as far as going down the stairs just like you said , and like the question in qbank its just the opposite DOWN WITH BAD--- THEN CANE--- THEN GOOD LEG...

hope this helps ...

I wish it did....because the reason I'm questioning it is BECAUSE of a Kaplan test question, in which the RIGHT answer had the man put the CANE down FIRST, then the bad leg, then the good.

Hence, my total loss here.

To be honest, it only makes SENSE to put the CANE on the step first if you're going down, to support that bad leg (why would you actually put your weak leg in such a vulnerable position?).

Can someone chime chime in here? Is Kaplan hopelessly screwing me up on this??

[RNsRWe, ASN, RN]

Alright, I just lifted this from arthritis.com:

"When ascending stairs, step first with the cane and good foot following with the bad side.

When descending stairs, step first with the bad foot and follow with the cane and good foot."

Looks like Kaplan strikes again. So, in other words, I DID get that question answered correctly, but the answer/rationale was wrong. Not surprising, actually....I've seen it a few other times, but where I KNEW it was a test mistake, not mine.

Like I need this!!

[pri4fun]

I have come across some quests too w/ kaplan where i am going ugh???

i am glad you brought up this cane topic, i hadnt really paid much attention to it, but now i think i understand...

[RNsRWe, ASN, RN]

Ok, I found the ACTUAL question, on Question Trainer Test #3; it's Question #29. I couldn't do a copy/paste, but I am typing it exactly here, so you can see what the confusion is. The rationales DON'T match up or remain consistent!

"The nurse in the outpatient clinic instructs a client diagnosed with right-sided weakness to walk down stairs using a cane. What behavior, if demonstrated by client, indicates to the nurse that teaching is successful?

1 - The client puts the right leg on the step, then the cane, followed by the left leg.

2 - The client leads with the cane, followed by the right leg and then the left leg."

3 - doesn't matter, totally wrong answer.

4 - doesn't matter, totally wrong answer.

Which is the correct answer?

According to the Kaplan rationales, it goes like this:

" 1- incorrect: to go down stairs, advance weak leg and cane first; to go up stairs, advance strong leg, then weak leg and cane.

2- CORRECT: to go down stairs, advance cane and weak leg, then strong leg; memory trick: the good goes up, the bad goes down."

I chose Answer #1. Made sense, even according to their rationales.

Does anyone else see a problem with this???

[RNsRWe, ASN, RN]

Just got this from the American Academy of Orthopedic Surgeons, which would make the Kaplan answer choice #2, the one they support, absolutely correct:

"When you walk, the cane and your injured leg swing and strike the ground at the same time. To start, position your cane about one small stride ahead and step off on your injured leg. Finish the step with your normal leg. To climb stairs, grasp the handrail (if possible) and step up on your good leg first, with your cane in the hand opposite the injured leg. Then step up on the injured leg. To come down stairs, put your cane on the step first, then your injured leg, and finally the good leg, which carries your body weight. "

I just wish it hadn't been so danged vague in the video, and that often-quoted "up with the good, down with the bad"....going downstairs isn't a reverse of going up, it's different, period. Going up, you LEAD with the good leg on the step first. Going down, you lead with the CANE on that step, then the bad leg goes down.

The rationales for not choosing #1 and choosing #2 aren't really correct statements themselves; the first rationale implies that the cane and leg are used simultaneously and they aren't. The rationale for #2 says the same thing, in reverse order (leg and cane, cane and leg, still simultaneous). They aren't. But the way the answer is written, exactly, for choice #2 would make #2 clearly correct. Yeesh.

Sorry if I seem like I'm beating this to death, but it's such a stupidly simple point and such an important one, because it constantly shows up. I can't afford to not get it right!