A case management nurse is arranging discharges for several clients. Which of the following interventions would the nurse recognize as suitable for non-skilled care?
Evaluating self-administration of insulin in a 68-year-old client with newly diagnosed diabetes mellitus
Auscultating lung sounds in a 76-year-old client with decompensated heart failure taking a diuretic
Monitoring blood pressure in an 86-year-old client with hypertension recently started on a new antihypertensive
Changing a dry dressing on a 78-year-old client with poor vision who had sustained a laceration on the lower leg
The Correct Answer is D
A. Evaluating self-administration of insulin involves assessing a client's ability to manage their medication, which requires skilled nursing assessment and education.
B. Auscultating lung sounds is a skilled nursing task involving clinical assessment of respiratory status.
C. Monitoring blood pressure is a skilled nursing task that requires clinical assessment, especially when adjusting medications.
D. Changing a dry dressing is considered non-skilled care as it primarily involves routine care and does not require advanced clinical skills. This task is appropriate for a non-skilled caregiver.
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Correct Answer is C
Explanation
A. Encouraging a positive attitude is more aligned with behavior change theories rather than the Health Belief Model, which focuses on perceived threats and benefits.
B. Tailoring interventions to readiness is more specific to the Transtheoretical Model rather than the Health Belief Model.
C. Providing educational materials to increase awareness of health risks is a core component of the Health Belief Model, as it aims to enhance perceived susceptibility and severity of health issues.
D. Group interaction and reinforcement are strategies more related to social support and behavioral theories rather than the Health Belief Model’s focus on individual perceptions and risks.
Correct Answer is D
Explanation
A. Limited vision at night does not necessarily meet the criteria for being homebound; the focus is more on the overall inability to leave home without considerable effort.
B. Being bedridden and requiring assistance to get into a wheelchair could indicate severe mobility issues, but it does not alone determine homebound status.
C. Living alone with children nearby does not impact the assessment of being homebound; it is more about the client's ability to leave the home.
D. Requiring a taxing effort to leave the home for a prescribed event meets the criteria for being homebound, as it demonstrates significant difficulty in leaving the home without considerable effort or assistance.
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