There are times when patients need to conserve their energy because their lives literally depend on it. Every effort to move is precious, and even small movements can significantly affect the patient’s condition. Certified nursing assistants must check the care plan carefully and strictly follow instructions for procedures and patient activities.
There are certain situations wherein a CNA must help preserve their patient’s energy, so their conditions do not worsen or their need for oxygen does not increase. Here are some cases where energy spending must be limited:
1. Heart conditions such as heart failure
Exerting effort could force the weakened heart to work harder, which could lead to complete failure and cardiac arrest.
2. Chronic liver disease such as liver cirrhosis
Overwhelming fatigue is a common symptom, so what energy is left must be reserved for meals and other important procedures.
3. Chronic lung disease such as COPD or chronic obstructive pulmonary disease
The lungs do not get enough oxygen, so every effort uses precious oxygen and energy.
Those who are recovering from stroke have severe weakness or paralysis, usually on one side of the body, and excess effort could trigger another stroke.
5. Muscle disorders such as myasthenia gravis
The muscles of patients with myasthenia gravis weaken after use, so every muscle movement is precious.
To conserve a patient’s energy, a CNA must find ways of doing daily patient activities with as little effort as possible. Let the tips below help you in similar situations:
1. Plan activities ahead of time. Cluster procedures to avoid disturbing the patient unnecessarily, but do not overdo it to the point of exhausting them. Have rest periods in between tiring steps.
2. Focus on the most important steps of a procedure and skip the unnecessary steps.
3. Schedule vital activities such as meals after taking medications that improve strength or breathing.
4. Request high-calorie, healthy foods that require less effort to eat, such as purees, yogurt, and bananas.
5. Offer raised toilet seats or a bedside commode, if needed.
6. If the patient is allowed to bathe in the bathroom, let them sit on a chair as you help bathe them.
7. Provide wheelchairs and other mobility devices when moving them from one place to another.
8. If transferring to a chair is tiring for the patient, use mechanical or electric lifters.
9. Use turning sheets to turn or move the patient in bed.
10. Avoid activities right after a meal. Wait at least half an hour before starting a task with them, because digestion uses energy.
11. Have patients choose clothes that open in front, with zippers or Velcro tape instead of buttons.
12. If they report constipation, inform the nurse immediately, because straining while moving their bowels spends a lot of energy.
13. Remind patients how they can save energy when they are moving on their own:
a. Use mechanical reachers when attempting to reach high places or picking up something from the floor.
b. Have other equipment for dressing available to the patient, such as buttonhooks, shoe horns, and sock
c. Have frequent rest periods.
d. Avoid working or moving in a hot room or a very cold place.
e. Do not lift heavy objects. Push, pull, or use carts instead.
f. Avoid bending over or standing up from a low position.
g. Perform grooming procedures while sitting down and leaning back in a chair.
h. Always have the call bell or any signaling devices within reach, so that they can ask for immediate assistance when necessary.
i. Introduce hobbies that do not require much energy expenditure, such as reading, doing puzzles, and writing.
j. If they have further concerns, motivate them to open up and refer to the nurse or physician as appropriate.
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