A nurse is assisting with the discharge of a client from acute care to home health care. Which of the following components of the medical record should the nurse provide to the home health agency?

Vital signs flow sheet

Nursing admission assessment

Current medications

Nurses' notes

Answer and Explanation

The Correct Answer is C

A) Vital signs flow sheet:

While vital signs are essential for assessing the client's health status, the home health agency typically focuses on the client's ongoing care needs rather than retrospective data such as vital sign trends.

B) Nursing admission assessment:

The nursing admission assessment provides valuable information about the client's initial condition upon admission to the acute care facility. However, the home health agency primarily requires information relevant to the client's current health status and ongoing care needs.

C) Current medications:

Providing the home health agency with a list of the client's current medications is essential for continuity of care. It allows the home health agency to ensure that the client receives the appropriate medications and dosages after discharge. This information helps prevent medication errors, adverse drug interactions, and omissions in the client's care plan. Additionally, the home health agency can use the medication list to reconcile medications and update the client's medication regimen as needed.

D) Nurses' notes:

While nurses' notes contain valuable information about the client's care during their stay in the acute care facility, they may not be immediately relevant to the home health agency's provision of care in the community setting. The focus of the home health agency is typically on the client's current status and needs rather than historical documentation.

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Correct Answer is B

Explanation

A) Administer PRN haloperidol IM to the client:

Administering haloperidol is not the first-line intervention for managing behavioral disturbances in clients with dementia, especially in response to acute agitation. While antipsychotic medications like haloperidol may be prescribed in some cases, they should be used judiciously due to the risk of adverse effects, particularly in elderly clients. Additionally, administering medication should not be the first action taken without attempting non-pharmacological interventions.

B) Engage the client in a repetitive activity as a distraction:

This is the most appropriate initial intervention when dealing with an agitated client with dementia. Engaging the client in a repetitive, calming activity can help redirect their focus and reduce agitation. Simple, familiar tasks or activities tailored to the client's preferences can be effective in providing comfort and reducing distress.

C) Apply wrist restraints to the client:

Using physical restraints should be avoided unless absolutely necessary for the safety of the client or others. Restraints can cause physical and psychological harm, increase agitation, and compromise the client's dignity and autonomy. Therefore, restraint use should be a last resort and implemented only after other interventions have been attempted and deemed ineffective or when there is an imminent risk of harm.

D) Place the client in a seclusion room:

Seclusion should not be used as an initial intervention for managing agitation in clients with dementia. Seclusion can exacerbate distress and increase feelings of isolation and fear, which may escalate agitation further. It should only be considered as a last resort for managing severe agitation or aggression when all other interventions have failed and there is a risk of harm to the client or others.

A. Incorporate the process change into daily practice within the facility. B. Determine if the implemented change has lowered the current infection rate. C. Select a potential intervention to lower the current infection rate. D. Identify current infection rates from facility data.

Correct Answer is D

Explanation

A) Incorporate the process change into daily practice within the facility: While incorporating process changes is an essential step in quality improvement, it should not be the first action taken. Before implementing changes, it is crucial to gather data and identify areas for improvement to ensure that interventions are targeted and effective.

B) Determine if the implemented change has lowered the current infection rate: Assessing the effectiveness of interventions is an important aspect of quality improvement, but it should occur after identifying baseline data and implementing interventions. Without baseline data, it is challenging to determine the impact of changes accurately.

C) Select a potential intervention to lower the current infection rate: While selecting interventions is a necessary step in quality improvement, it should follow the identification of current infection rates and areas for improvement. Without data on current infection rates, it is difficult to select appropriate interventions.

D) Identify current infection rates from facility data: This is the correct first action when initiating a quality improvement program to address healthcare-associated infections. Gathering data on current infection rates provides a baseline for assessing the problem's magnitude and identifying areas for improvement. It allows healthcare providers to target interventions effectively and evaluate their impact over time.

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A nurse is assisting with the discharge of a client from acute care to home health care. Which of the following components of the medical record should the nurse provide to the home health agency?

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