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A nurse is collaborating with the interprofessional team and reviewing a client's electronic medical record of a post-operative client.

Exhibits

Click to highlight the findings that the nurse should recommend be addressed by the case manager. To deselect a finding, click on the finding again.

Nurses' Notes

1315:

Client is postoperative following an open cholecystectomy. Client's partner is at bedside. Surgical dressing intact, with small amount of serosanguineous drainage on dressings. Client reports pain as 5 on a scale of 0 to 10. Client requests a dose of their pain medication. Client expresses concern regarding the cost of prescription medications. Client reports being unable to find transportation to follow-up appointment.

Plan of Care

1300:

Case management referral for discharge planning. Client will need home health referral for dressing changes. Client to follow up with the provider at the clinic in one week.

A.

Client's partner is at bedside

B.

dressing intact

C.

small amount of serosanguineous drainage on dressings

D.

reports pain as 5

E.

Client requests a dose of their pain medication

F.

expresses concern regarding the cost of prescription medications

G.

unable to find transportation

H.

home health referral

Answer and Explanation

The Correct Answer is ["D","E","F","G","H"]

Rationale

  • Client reports pain as 5 on a scale of 0 to 10. The case manager can work with the healthcare team to ensure adequate pain management strategies are in place.
  • Client requests a dose of their pain medication. This indicates ongoing pain and the need for effective pain management.
  • Client expresses concern regarding the cost of prescription medications. The case manager can assist with identifying affordable medication options or connecting the client with financial assistance programs.
  • Client reports being unable to find transportation to follow-up appointment. The case manager can help arrange transportation or connect the client with community resources that can provide transportation assistance.


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Related Questions

Correct Answer is A

Explanation

A. Initiating oxygen therapy for a client with COPD is a priority because oxygenation is critical for clients with respiratory conditions. Hypoxia can lead to serious complications, making this intervention urgent.
B. While initiating a 24-hour urine collection is important for monitoring kidney function, it does not require immediate action compared to the need for oxygen therapy in a client with respiratory distress.
C. Administering antibiotics is essential, especially for a client with an infection like MRSA; however, the need for immediate oxygen therapy takes precedence over medication administration.
D. Changing the dressing for a decubitus ulcer is important for preventing infection and promoting healing but is not as time-sensitive as ensuring adequate oxygenation for the client with COPD.

Correct Answer is C

Explanation

A. While the pharmacy should be notified of errors to improve systems, the immediate priority is the client's safety and the provider's notification. Reporting to the pharmacy manager is a secondary administrative step, not the first or most critical action.
B. Incident reports should not be placed in the client's medical record, as they are separate documents meant for internal review and quality improvement.
C. When a medication error occurs, the nurse’s primary responsibility is to ensure the safety of the client and maintain an accurate medical record of what actually happened to the patient.
D. Contacting the nurse from the previous shift may be necessary for understanding the situation, but the priority is to report the incident properly to ensure patient safety.

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