Nokea
A nurse is reviewing the discharge plan with a patient who had major abdominal surgery. Which statement by the nurse is most appropriate?
- A. I'll bet you will be so glad to be home and sleep in your own bed.
- B. Tell me about your understanding of your recovery needs after discharge.
- C. Be sure to take your pain medications and change your dressing.
- D. You will just be fine! Please stop worrying.
Correct Answer: B
Rationale: The purpose of discharge planning is to ensure for continuity of care for the patient and family needs. The nurse uses open-ended assessment questions to begin a planning session. Essential components of discharge planning include assessing the strengths and limitations of the patient, the family or support person, and the environment; implementing and coordinating the care plan; considering individual, family, and community resources; and evaluating the effectiveness of care. Answers a and c are examples of communication or interventions, which may be included after an assessment. The statement 'You will just be fine! Please stop worrying,' is a clich?© and is avoided.
You may also like to solve these questions
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 discharge nurse is evaluating patients and their families to determine the need referrals to other facilities after hospitalization. Which patients will the nurse recommend for these services? Select all that apply.
- A. Older adult diagnosed with dementia in the hospital
- B. Adult diagnosed with Parkinson disease
- C. Adult woman receiving chemotherapy for breast cancer
- D. Adolescent being discharged with a cast on his leg
- E. New mother who delivered a healthy infant via a cesarean birth
- F. Adult man diagnosed with end-stage cancer
Correct Answer: A,B,F
Rationale: The patients who are most likely to need a formal discharge plan or referral to another facility are those who are emotionally or mentally unstable (e.g., those with dementia), those who have recently diagnosed chronic disease (e.g., Parkinson disease), and those who have a terminal illness (e.g., end-stage cancer). Other candidates include patients who do not understand the treatment plan, are socially isolated, have had major surgery or illness, need a complex home care regimen, or lack financial services or referral sources.
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 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.
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.