36th Exam (Jan 2024) Afternoon Q87 Kaigo Fukushishi
Question (original Japanese)
左片麻痺の利用者が、端座位でズボンを着脱するときの介護に関する次の記述のうち、最も適切なものを1つ選びなさい。
- 1最初に、左側の腰を少し上げて脱ぐように促す。
- 2右膝を高く上げて、脱ぐように促す。
- 3左足を右の大腿の上にのせて、ズボンを通すように促す。
- 4立ち上がる前に、ズボンを膝下まで上げるように促す。
- 5介護福祉職は右側に立って、ズボンを上げるように促す。
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Correct answer 3
Key pointWhen a person with hemiplegia puts on pants, put the affected leg on the unaffected thigh and pass it through.
Explanation
When dressing in a sitting position, crossing the affected (left) leg over the unaffected (right) thigh makes it easier to pass the leg through the pants (put on the affected side first, take off the unaffected side first: 着患脱健).
- 1: When taking pants off, the person puts weight on the unaffected (right) side or lifts the hips slightly on the unaffected side. Lifting from the paralyzed left side of the hips is difficult, so this is wrong.
- 2: Raising the unaffected knee high makes the sitting position unstable and causes a risk of falling.
- 4: Wrong, because the pants are pulled up to above the knees (the thighs) before standing up.
- 5: Wrong, because the caregiver stands on the affected side (left side), where the person is more likely to fall.
Explanation in Japanese
端座位で着る場合は、患側（左）の足を健側（右）の大腿の上にのせて組むと、ズボンを通しやすくなります（着患脱健）。
- 1：脱ぐときは、健側（右）に体重をかけたり健側の腰を少し浮かせたりして脱ぐ。麻痺のある左側の腰から上げるのは難しいので誤り。
- 2：健側の膝を高く上げると座位が不安定になり転倒の危険がある。
- 4：立ち上がる前に、ズボンを膝の上（大腿部）まで上げておくので誤り。
- 5：介護者は転倒しやすい患側（左側）に立つので誤り。