A nurse is caring for a client who has an acute case of cellulitis. After implementing a treatment protocol with the client, the client reports that they have had difficulty finding a job for almost a year and they sometimes skip meals to save money. Which problem is the priority for the nurse to address in the care plan?

Choice A: Implementing the Teach Back Method When Prescribing Medication
The Teach Back Method is an effective communication strategy where healthcare providers ask clients to repeat back the information given to ensure understanding. While this method can improve medication adherence and health literacy, it does not directly address the broader systemic issues related to poverty. It is a useful tool but not the most impactful intervention for breaking the cycle of poverty.

Choice B: Replacing Medicare Programs with Medigap Policies
Medigap policies are supplemental insurance plans that cover costs not included in traditional Medicare. However, replacing Medicare programs with Medigap policies would not necessarily improve outcomes for clients impacted by poverty. Medigap policies can be expensive and may not be affordable for low-income individuals. This intervention does not address the root causes of poverty or improve access to essential health services.

Choice C: Eliminating the Use of Client Portals or Virtual Visits
Eliminating client portals or virtual visits would likely have a negative impact on client outcomes, especially for those in poverty who may have limited access to transportation. Virtual visits and client portals provide convenient access to healthcare services, allowing clients to communicate with providers, access medical records, and receive care without the need for in-person visits. Removing these options would reduce access to care for many individuals.

Choice D: Opening a Community Health Center in an Underserved Area
This is the correct choice. Opening a community health center in an underserved area directly addresses the lack of access to healthcare services, which is a significant barrier for individuals living in poverty. Community health centers provide comprehensive primary care, preventive services, and support for managing chronic conditions. They often offer sliding scale fees based on income, making healthcare more affordable and accessible for low-income populations. By improving access to healthcare, community health centers can help break the cycle of poverty and improve overall health outcomes.

Choice A Reason:
Assessing the client's wound is a task that requires clinical judgment and expertise, which falls under the scope of practice of a registered nurse (RN) or licensed practical nurse (LPN). Assistive personnel (AP) are not trained or authorized to perform assessments, as these require a higher level of clinical knowledge and decision-making.

Choice B Reason:
Notifying the case manager of the client's wishes for community resources involves communication and coordination of care, which are responsibilities typically handled by an RN or LPN. This task requires understanding the client's overall care plan and the ability to communicate effectively with other healthcare professionals.

Choice C Reason:
Reviewing the client's medications is a task that involves understanding the medications, their purposes, potential side effects, and interactions. This requires clinical knowledge and judgment, which are beyond the scope of practice for AP. Medication review is typically performed by an RN or LPN.

Choice D Reason:
Assisting the client with bathing and oral care is a task that falls within the scope of practice for AP. These activities are part of the basic care tasks that AP are trained to perform. They involve helping the client with daily living activities, which do not require clinical judgment or decision-making.