A community health nurse is planning a smoking cessation class. Which of the following factors will have the greatest effect on the success of the class?

Choice A reason: The client dressing her affected side first is not a finding that the nurse should report to the interprofessional care team, as it indicates that the client is following the proper technique for dressing after a stroke. Dressing the affected side first helps the client maintain range of motion and prevent contractures of the affected limbs.

Choice B reason: The client bearing weight on their arms when using crutches is not a finding that the nurse should report to the interprofessional care team, as it is a normal and expected way of using crutches. Bearing weight on the arms helps the client balance and support their body weight while walking with crutches.

Choice C reason: The client coughing when swallowing her medications is a finding that the nurse should report to the interprofessional care team, as it indicates that the client may have dysphagia, or difficulty swallowing, which is a common complication of stroke. Dysphagia can increase the risk of aspiration, pneumonia, dehydration, and malnutrition. The nurse should assess the client's swallowing ability and refer them to a speech-language pathologist for further evaluation and intervention.

Choice D reason: The client's caregiver filling a pill organizer weekly is not a finding that the nurse should report to the interprofessional care team, as it is a positive and helpful way of managing the client's medications. Filling a pill organizer weekly can help the client and the caregiver remember the medication names, doses, and schedules, and prevent medication errors or omissions.

Choice A reason: Organizing an influenza immunization clinic with the American Red Cross is a service that the nurses should plan to provide to the congregation, as it is consistent with the role and scope of parish nursing. Parish nurses, or faith community nurses, are registered nurses who provide education, counseling, referral, advocacy, and volunteer coordination within the context of their faith community¹. They focus on holistic healing and prevention of illness, rather than hands-on care². Organizing an influenza immunization clinic is an example of a preventive and educational service that can benefit the health of the congregation and the community.

Choice B reason: Performing wound care in the home of members is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as wound care, medication administration, or blood pressure monitoring². They may refer members to other health care providers or agencies for these services, or teach members how to perform self-care³.

Choice C reason: Providing end of life care for members who are terminal is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as pain management, symptom control, or palliative care². They may provide spiritual and emotional support, counseling, and advocacy for members who are terminal, or refer them to hospice or other end of life care services³.

Choice D reason: Facilitating discharge from the facility to the home is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide case management, discharge planning, or home health care². They may collaborate with other health care professionals or community agencies to ensure continuity of care and smooth transition for members who are discharged from the facility to the home³.