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A discharge nurse manager is preparing the plan for a patient returning home after receiving a kidney transplant. What actions will the nurse perform to ensure continuity of care? Select all that apply.
- A. Conduct an admission health assessment
- B. Evaluate the effectiveness of the current nursing care plan
- C. Participate in transferring the patient to the postoperative care unit
- D. Make referrals to appropriate facilities
- E. Maintain records of patient satisfaction with services received
- F. Assess the strengths and limitations of the patient and family
Correct Answer: B,D,F
Rationale: The primary roles of the discharge planner as patients move from acute to home care are evaluating the nursing plan for effectiveness of care, making referrals for patients, and assessing the strengths of patients and their families. The staff typically performs an admission health assessment and assists with patient transfers from the OR. In most facilities, maintaining records of patient satisfaction is the role of the public relations manager or office manager.
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A home care nurse is observing the patient's family member perform a wound irrigation and dressing change for a postoperative wound dehiscence containing purulent drainage. In which situation will the nurse provide additional education?
- A. The family member places the old dressing in a separate bag at the bedside.
- B. The patient takes an analgesic a half-hour prior to the dressing change.
- C. The family member states they washed their hands an hour ago.
- D. The patient returns to bed during the dressing change.
Correct Answer: C
Rationale: The nurse teaches the patient and family to effectively wash their hands before and after having direct contact with the patient, before performing invasive procedures, when handling dressing or touching open wounds, and when administering medications or feeding the patient. All other options are correct.
A nurse asks the AP to prepare the hospital room for a new ambulatory patient. Which aspect of the room will the nurse ask the AP to correct?
- A. The bed linens are folded back.
- B. A hospital gown is on the bed.
- C. Equipment for taking vital signs is in the room.
- D. The bed is in the highest position.
Correct Answer: D
Rationale: A properly prepared hospital room includes a bed in the lowest position for an ambulatory patient, an open bed with top linens folded back, routine and special equipment and supplies assembled, and the physical environment of the room adjusted.
When transferring a patient from the operating room to the medical-surgical unit, a nurse uses the SBAR format for handoff communication. Place the components of the SBAR communication (Situation, Background, Assessment, and Recommendations) in their proper order.
- A. This 20-year-old patient presented to the ER with right lower quadrant pain, fever, and an elevated WBC count.
- B. The patient is postlaparoscopic appendectomy.
- C. The patient may need pain medication in 30 minutes.
- D. The patient is sleepy, but responsive; five small bandages on the abdomen are clean and dry.
Correct Answer: B,A,C,D
Rationale: The SBAR communication for this patient should be: The patient is post laparoscopic appendectomy. This 20-year-old patient presented to the ER with right lower quadrant pain, fever, and an elevated WBC count. The patient may need pain medication in 30 minutes. The patient is sleepy, but responsive; there are five small bandages on the abdomen that are clean and dry.
A visiting nurse is performing the initial assessment and plan for a patient who receives Medicare and was recently discharged from the acute care hospital. Before implementing the plan of care, what follow-up is required by the nurse?
- A. Validating the patient's consent for care
- B. Obtaining the health care provider's signature and approval
- C. Determining how the patient will pay for services
- D. Ensuring that a family member or friend can assist with implementation
Correct Answer: B
Rationale: The nurse assesses the patient eligible for home services and presents the plan to the health care provider for approval. This approval the plan allows for provision of care and reimbursement of services.
A home health nurse is scheduled to visit a patient recently discharged from the hospital with a new colostomy. During the entry phase of the home visit, what actions will the nurse perform? Select all that apply.
- A. Collect information about the patient's diagnosis, surgery, and treatments
- B. Call the patient to make initial contact and schedule a visit
- C. Develop rapport with the patient and their family
- D. Assess the patient to identify their needs
- E. Assess the physical environment of the home
- F. Evaluate safety issues including the neighborhood in which the patient lives
Correct Answer: C,D,E
Rationale: In the entry phase of the home visit, the nurse develops rapport with the patient and family, makes assessments, determines nursing diagnoses, establishes desired outcomes, plans and implements prescribed care, and provides teaching. In the pre-entry phase of the home visit, the nurse collects information about the patient's diagnoses, surgical experience, socioeconomic status, and treatment orders. In the pre-entry phase, the nurse also gathers supplies needed, makes an initial phone contact with the patient to arrange for a visit, and assesses the patient's neighborhood for safety issues.