A nurse is caring for a client who has right-sided paralysis following a cerebrovascular accident. Which of the following prescriptions should the nurse anticipate to prevent a plantar flexion contracture of the affected extremity?
A.
Sequential compression device
B.
Abduction splint.
C.
Ankle-foot orthotic.
D.
Continuous passive motion machine.
The Correct Answer and Explanation is:
The correct answer is C. Ankle-foot orthotic.
Explanation
Ankle-foot orthotics (AFOs) are devices specifically designed to support the foot and ankle in a proper position, which is crucial for preventing and managing contractures in clients with paralysis or weakness. After a cerebrovascular accident (CVA), also known as a stroke, clients may experience varying degrees of paralysis on one side of their body. This paralysis can lead to muscle imbalances and spasticity, especially in the affected limbs. One common issue is the development of plantar flexion contractures, where the foot becomes fixed in a downward position, making it difficult to achieve a normal walking pattern or maintain a functional position of the limb.
AFOs are designed to prevent these contractures by keeping the foot and ankle in a neutral or dorsiflexed position. This positioning helps to stretch the shortened muscles and tendons on the back of the leg and maintain the length of these structures, thereby preventing the foot from becoming fixed in plantar flexion. The use of AFOs can also promote proper alignment and stability during ambulation, enhancing mobility and function.
In contrast, the other options are not specifically intended for preventing plantar flexion contractures:
- Sequential compression devices (A) are primarily used to prevent deep vein thrombosis (DVT) by improving blood circulation in the legs, not for preventing contractures.
- Abduction splints (B) are typically used to keep the hip in an abducted position, often for hip dysplasia or after hip surgery, and are not designed for managing plantar flexion issues.
- Continuous passive motion machines (D) are used to maintain joint mobility and prevent stiffness by passively moving the joints through a range of motion. They are often used post-operatively or for specific joint rehabilitation but are not specifically designed to prevent plantar flexion contractures.
Therefore, C. Ankle-foot orthotic is the most appropriate choice to prevent a plantar flexion contracture in the affected extremity following a cerebrovascular accident.