Published Sep 7, 2013
Jill2Shay
131 Posts
I have my first real clinical shift of my med-surg block tomorrow. I just picked my patient and ma writing the care plan now.
One of the activity orders states the patient can dangle for 45 minutes every 4 hours. What would the purpose of this be?
I understand dangling in regards to orthostatic hypotension and allowing the blood pressure to regulate before standing, but what does just dangling accomplish?
I've done some searches with different search terms, but nothing difininitive comes up as the benefit of dangling in bed without getting up. The order doesn't say anything about extending the knees or any other ROM activity.
nurseprnRN, BSN, RN
1 Article; 5,116 Posts
I have my first real clinical shift of my med-surg block tomorrow. I just picked my patient and ma writing the care plan now. One of the activity orders states the patient can dangle for 45 minutes every 4 hours. What would the purpose of this be?I understand dangling in regards to orthostatic hypotension and allowing the blood pressure to regulate before standing, but what does just dangling accomplish?I've done some searches with different search terms, but nothing difininitive comes up as the benefit of dangling in bed without getting up. The order doesn't say anything about extending the knees or any other ROM activity.
If your patient is going to get lightheaded when he becomes upright, it's better to find out when he's sitting than already standing at the side of the bed so you can lie him down instead of catching him. :) If he's going to get significant postural hypotension it won't be as extreme when he sits as when he stands.
I get that part, but why dangle for 45 minutes every 4 hours?
To teach that sympathetic nervous system and cardiovascular system to get back to work-- think feedback from the sympathetics in the leg arteries, pressure sensors in the carotid bodies, venous return changes and contractility...
Esme12, ASN, BSN, RN
20,908 Posts
dangling for 45 mins every 4 hours seems like along time. But.....a MD will order dangle to make the patient move and mobilize secretions lessening the change of pneumonia/atelectasis without having to bear weight.....and lessen the opportunity for clots to form.
I don't like dangling for extended peroids of time because of the likelihood that the patient will tip forward and fall. The every four hours is to ensure someone carries this out to get this person to move. You can't leave a patient dangling alone unless they can sit at the side of the bed by themselves. Many COPD patients will dangle hunched over a bedside stand in a tripod like position to help them breathe.
Thank you!
And thank you too!
You're welcome.
MendedHeart
663 Posts
Just curious what kind of pt was this, diagnosis?
When I first read this, I got the impression that this patient was on bedrest but was allowed to dangle q4
If the pts meaks come arounf 0800,1200,1600ish arent these meal times...easy way to kill two birds with one stone
aTOMicTom
213 Posts
I'm still a student; I learn something every day here on AN. Today: DANGLING!
hee hee, it's also something the doctor orders for bedridden pts. Never heard this before.
Thanks guys!