The female older adult has diabetes mellitus and requires hemodialysis for renal failure. She is discharged to home to recover from a sternal wound infection and coronary artery bypass graft surgery (CABG). A home care nurse will provide wound care
Which is the major justification for complete and accurate documentation of this older adult's care? a. Requires complex health care
b. Has needs in multiple settings
c. Is at risk for iatrogenic problems
d. Has significant health care expenses
A
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A Correct. The major reason that documentation of her health care must be accu-rate and complete is that she has complex health care needs in multiple settings and experiences a high risk for iatrogenic problems and high reimbursement expenses. The duration of her care is likely to be very lengthy because a sternal wound infection following CABG is very serious owing to the potential for sternal osteomyelitis. In addition, individuals with diabetes are at very high risk for infection and are slow to heal.
B Incorrect. The complexity of her care includes receiving care in multiple settings: at home, at dialysis, and in primary care for postdischarge follow-up care. For an older adult with diabetes, coronary artery disease, renal failure, and a serious infection, each facet of her health care depends on complete and accurate data on the other aspects of her care to help her achieve optimal health and wellness.
C Incorrect. This older adult is at risk for iatrogenic problems because of the com-plexity of her care. Each type of care, each illness or condition, and each setting exposes this older adult to a separate set of risks. In addition, individuals with diabetes can have peripheral neuropathies that increase the risk for falls and in-juries.
D Incorrect. This older adult incurs health care expenses dealing with complex health care requirements including a recent hospital stay for surgery and com-plicated by an infection, ongoing needs for hemodialysis, and home care. Be-cause much of the care is nurse driven, documentation is the basis for which reimbursement is provided.
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