A nurse is assessing the skin turgor of an older adult client. In which of the following areas should the nurse lift the skin?

Rationale:

A. A liaison negotiates with service providers to obtain accessible cost-effective care: One of the primary roles of a nurse case manager as a liaison is to connect clients with necessary healthcare services. This includes coordinating with service providers, negotiating costs, and ensuring that clients have access to appropriate, cost-effective care to meet their needs.

B. A liaison promotes interprofessional communication: While promoting communication among healthcare team members is an important function of case management, it is more closely aligned with the role of a coordinator rather than the liaison function, which focuses on external connections and access.

C. A liaison monitors the use of clinical practice guidelines for delivery of care: Monitoring adherence to clinical guidelines is part of quality assurance and clinical oversight, which falls under the role of a case manager or quality improvement nurse, not specifically the liaison role.

D. A liaison measures the quality of services being provided: Measuring service quality is a responsibility related to quality management or evaluation within case management, not the primary function of a liaison. The liaison role emphasizes connecting clients to resources rather than evaluating service performance.

Rationale:

A. Place an ice pack directly on the skin of the affected joints: Ice should never be applied directly to the skin as it can cause frostbite or skin damage. It should be wrapped in a cloth or towel before use. While cold therapy can reduce inflammation and numb pain, safety precautions are essential.

B. Limit dietary intake of phosphorus: Phosphorus restriction is not relevant for osteoarthritis management. Dietary modifications for osteoarthritis focus more on maintaining a healthy weight and anti-inflammatory nutrients rather than phosphorus intake.

C. Place a large pillow under the knees when sleeping: Placing a large pillow under the knees can hyperflex the joints and increase strain on the knees and hips. Proper positioning involves keeping joints in a neutral or slightly extended position to reduce discomfort and prevent contractures.

D. Take a hot shower every day: Heat therapy helps relax muscles, relieve stiffness, and improve joint mobility in clients with osteoarthritis. Warm showers or moist heat applications are effective nonpharmacological interventions for managing pain and promoting comfort.