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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Related Questions
Correct Answer is C
Explanation
A. Promoting healthier behavior in children is an important health objective, but Healthy People 2030 focuses on broader goals that encompass multiple aspects of public health.
B. Providing primary care to all citizens is a key health goal but is not the primary focus of Healthy People 2030. The initiative includes various strategies and goals, rather than solely focusing on universal primary care.
C. Reducing health disparities is a central goal of Healthy People 2030, aiming to address and minimize differences in health outcomes among different population groups.
D. Curing cancer is an important health issue, but Healthy People 2030 focuses on broader public health goals and strategies rather than specific cures for diseases.
Correct Answer is B
Explanation
A. Documenting the time of death is not an immediate concern during the process of terminal delirium and does not directly address the patient's comfort.
B. Limiting environmental noise helps reduce stimulation, which can be beneficial for a patient experiencing terminal delirium and unresponsiveness, helping to maintain a calm environment.
C. While taking respite time may be necessary for family members, it does not directly address the needs of the patient with terminal delirium.
D. Telling the patient it is okay to let go is emotionally supportive but does not address the immediate need to manage symptoms and provide comfort during terminal delirium.
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