Basic Restorative Services
What the exam expects you to know
Restorative care means helping residents keep or regain function: range of motion, positioning, transferring, ambulation, assistive devices, splints, and bowel and bladder retraining. The guiding rule is use it or lose it, so never do for a resident what they can do for themselves; provide set-up and supervision instead.
Range of motion may be active, done by the resident, or passive, done by you. Move the joint gently, never force past resistance or pain, and stop and report pain, swelling, or a change in ability. Position with body alignment and change position on schedule to protect skin. Apply and remove splints only as ordered and check the skin. For ambulation, apply a gait belt, stand on the resident's weaker side, and walk at their pace. A cane is held on the stronger side; with a walker the resident steps into it and does not use furniture instead. For transfers, lock the brakes, raise the bed to a safe height, and pivot toward the stronger side. Bowel and bladder training uses scheduled toileting, adequate fluids, and prompt reporting of changes.
Traps built into questions
Trap answers include holding the cane on the weak side, pulling a resident up by the arms or shoulders, skipping the gait belt, leaving a splint on longer than ordered, and forcing a joint to stretch it further.
Worked example
A resident has weakness on the right after a stroke. When ambulating with a cane, the cane goes in the left hand, and you stand on the right side with the gait belt in place.