A nurse is providing discharge teaching to the parents of a toddler who has cystic fibrosis.

Which of the following instructions should the nurse include?

The correct answer is Choice d. Positioning both hands on the grips with his elbows slightly flexed.

Choice A rationale:

• Moving both crutches with the stronger leg forward first is incorrect for a three-point gait.This describes a two-point gait,which is used when a client can bear weight on both legs.In a three-point gait,the client bears weight on the unaffected leg and the crutches,not the stronger leg.
• This action would put excessive weight on the affected leg and could potentially compromise healing or cause further injury.

Choice B rationale:

• Supporting his body weight while leaning on the axillary crutch pads is also incorrect.This can lead to nerve damage in the armpits and should be avoided.
• The weight should be distributed through the hands and wrists,not the armpits.

Choice C rationale:

• Stepping with his affected leg first when going up stairs is incorrect and potentially dangerous.The client should lead with the stronger leg when going up stairs to maintain balance and control.

Choice D rationale:

• Positioning both hands on the grips with his elbows slightly flexed is the correct action for using crutches with a three-point gait.This allows for proper weight distribution,balance,and control of the crutches.
• It also helps to prevent fatigue and strain in the arms and shoulders.

Key points to remember about the three-point gait:

• Weight is borne on the unaffected leg and the crutches,not the affected leg.
• The crutches and the unaffected leg move forward together,followed by the affected leg.
• The client should look ahead,not down at their feet.
• The client should take small,even steps.
• The client should rest as needed.

Encourage collaboration between the two nurses when making the assignments. This is because collaboration is one of the most effective conflict-resolution strategies in nursing, as it involves finding a mutually beneficial solution that satisfies both parties and improves the quality of care. Collaboration can also foster trust, respect, and teamwork among nurses, which can boost morale and efficiency.

Choice B is wrong because telling the nurses that the assignments will be more equitable in the future does not address the root cause of the conflict or involve the nurses in the decision-making process.

It also implies that the charge nurse admits to being unfair, which can damage their credibility and authority.

Choice C is wrong because asking each nurse to take turns making the assignments does not resolve the conflict, but rather avoids it. Avoidance is one of the least effective conflict management strategies in nursing, as it results in not addressing the issue or finding a common ground.

Avoidance can also lead to resentment, frustration, and poor communication among nurses.

Choice D is wrong because arranging for the nurses to have as few shifts together as possible also does not resolve the conflict, but rather accommodates it. Accommodation is another ineffective conflict management strategy in nursing, as it involves giving in to one party’s demands or preferences at the expense of another’s.

Accommodation can also create a sense of inequality, injustice, and dissatisfaction among nurses.

Normal ranges for conflict-resolution strategies in nursing are not applicable, as different situations may require different approaches.

However, some general guidelines are to use collaboration when both parties have important goals or interests, compromise when both parties have some common ground or willingness to give up something, competition when one party has a clear advantage or authority, avoidance when the conflict is trivial or temporary, and accommodation when one party values harmony or relationships more than their own goals or interests.