A nurse is caring for a client who was admitted for an exacerbation of their COPD. The client will be discharged with a new prescription for oxygen therapy and will need assistance with activities of daily living. Which of the following referrals should the nurse obtain for the client?
Case manager
Hospice care facility
Long term care facility
Pharmacist
The Correct Answer is A
A. Case manager A case manager helps coordinate home oxygen therapy, arranges for home health services, and ensures the client has access to needed resources, such as durable medical equipment and personal assistance for ADLs.
B. Hospice care facility Hospice is appropriate for clients with a terminal illness and a life expectancy of 6 months or less. COPD is chronic but not necessarily end-stage.
C. Long-term care facility This client is not indicated for long-term institutional care but rather for home-based support.
D. Pharmacist While a pharmacist is important for medication education, they do not coordinate oxygen therapy or ADL assistance.
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Related Questions
Correct Answer is C
Explanation
A. Report the incident to the pharmacy. While the pharmacy may need to be informed, client safety is the priority. The immediate concern is monitoring the client for opioid overdose effects.
B. Notify the client's provider. The provider should be notified, but assessing the client's condition comes first so that the nurse can provide accurate information about any potential adverse effects.
C. Measure the client's respiratory rate. The priority action is to assess the client for signs of opioid toxicity, especially respiratory depression. Morphine can cause decreased respiratory rate, sedation, and hypotension. If the respiratory rate is dangerously low (e.g., below 12 breaths per minute), interventions such as administering naloxone (Narcan) may be necessary.
D. Complete an incident report. An incident report should be completed, but client safety and assessment take priority before documentation.
Correct Answer is D
Explanation
A. "Submitting an incident report to risk management following a client fall." While this is important for safety and quality improvement, it is not a direct act of client advocacy.
B. "Documenting the effectiveness of pain medication in the client's health record." This is a critical part of nursing documentation but does not actively advocate for the client.
C. "Asking another nurse to check a medication calculation for a client." This promotes medication safety, but it is not an example of client advocacy.
D. "Informing the family of a deceased client of the client's wish to be an organ donor." Advocacy means ensuring the client’s wishes are honored, especially in sensitive situations like organ donation.
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