While recovering in the CCU, M.M. tried to get up out of the bed, fell, and fractured her right humerus. Because of the surgical risks involved, M.M. was treated conservatively and put in a full arm cast. She is transferred back to your floor
A case manager (CM) has been asked to evaluate M.M.'s home to see whether she can be discharged to her own home or will need to stay in a long-term care facility.
Identify at least eight things that the CM would assess.
M.M.'s nutritional intake over the past few weeks has been poor. She also has increased
nutritional needs because of her fractured arm. What are some of the nutritional needs that
should be met? What would you recommend to help her with this?
• What sort of support will she have at home for activities of daily living (ADLs), self-care, home
maintenance, and so on?
• Is there telephone service?
• How many steps are in the home or apartment? Are her bedroom and a bathroom downstairs?
• Is there a danger of tripping on throw rugs, loose carpeting, and so on?
• Are there handrails in stairways?
• How wide are the doorways?
• Where are the bathrooms? Does she have to negotiate steps to get there?
• Can the toilet seat be raised and railings applied?
• Is the lighting adequate?
• What is she going to do for meals, grocery shopping, and laundry?
• Can she get to a refrigerator? Will she be able to heat her meals?
• Will someone check on her every day? Help her with medications?
• Does she have sufficient lower body strength to ambulate independently and safely?
• Are there Spanish-speaking health care workers available to work with M.M.?
• It is important that M.M. get a consultation with a registered dietitian (RD) who will assess her
additional nutritional needs. This should be completed as soon as possible and certainly before
discharge.
• She is going to need help meeting her increased caloric, protein, calcium, vitamin, and mineral
needs to promote healing. The RD can assist with suggesting supplements that can help with
intake of these nutrients yet still avoid increasing her sodium and fat intake.
• Have the family bring food from home.
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A. One hour or more before a meal B. Only after an 8-hour fast C. Only after the patient has missed a meal D. At least 2 hours after a meal E. With liquids but not solids within 12 hours
Rho(D) immune globulin will be ordered postpartum if which situation occurs?
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Which actions would result in a greater number of nurses entering and staying in practice, given today's state of nursing? (Select all that apply.)
a. Determine why few African-American women enter graduate school. b. Provide incentives for minorities and men to enter nursing. c. Obtain grant funding to increase the number of faculty members and scholarship availability for students entering baccalaureate nursing programs. d. Survey nurses to determine why their job satisfaction is lower than that of other health care professions. e. Develop ad campaigns that target younger students.
A patient who is to receive a third round of combination chemotherapy today reports that mouth sores were present for 4 days within a week of receiving the last round of chemotherapy. What is your best action?
a. Hold today's dose of chemotherapy and notify the prescriber immediately. b. Ask the patient whether sores were also present after the first round of chemotherapy. c. Reassure the patient that this is an expected chemotherapy side effect and no action is needed. d. Administer the chemotherapy as prescribed and call the prescriber to determine whether preventive drugs are needed.