A nurse is discussing with another nurse how health outcomes for underinsured clients can be improved by returning to school to achieve a higher level of education. Which of the following rationales should the nurse include in the discussion?

Choice A Reason:
My community is struggling with high morbidity due to heart health, so this initiative has merit. This statement indicates a clear understanding of the Million Hearts initiative, which aims to prevent heart attacks and strokes by improving cardiovascular health. Recognizing the high morbidity due to heart health issues in the community aligns with the initiative's goals, making it a suitable and beneficial program to implement.

Choice B Reason:
These initiative strategies are still in the experimental stage and have questionable merit in practice. This statement is incorrect because the Million Hearts initiative is a well-established program with proven strategies to reduce cardiovascular disease. It is not in the experimental stage and has demonstrated effectiveness in various communities.

Choice C Reason:
It is a local initiative and should not be used outside my state. This statement is incorrect as the Million Hearts initiative is a national program in the United States, designed to be implemented across different states and communities. It is not restricted to any specific locality and can be adapted to meet the needs of various populations.

Choice D Reason:
I will need to get a doctor's order or directive from the community health lead before considering outside initiatives. While collaboration with healthcare providers and community leaders is important, this statement does not reflect an understanding of the initiative itself. The Million Hearts initiative can be implemented by various stakeholders, including nurses, without requiring a specific directive from a doctor or community health lead.

Choice A Reason:
Reinforcing past teachings on how to read food labels is an important educational intervention. It helps the client make informed dietary choices, which can be crucial in managing heart failure. However, this intervention is more aligned with secondary prevention, which focuses on early detection and management of disease risk factors to prevent progression. Tertiary prevention, on the other hand, aims to manage and mitigate complications of an already established disease.

Choice B Reason:
Tertiary prevention focuses on managing and mitigating the effects of an existing disease to prevent complications and improve quality of life. In the context of heart failure, this involves monitoring and managing symptoms to prevent disease progression and hospitalizations. Reviewing the client's daily weights helps detect early signs of fluid retention, a common issue in heart failure, allowing for timely interventions.

Choice C Reason:
Reminding the client to ask for the pneumococcal vaccine during their next provider appointment is a preventive measure aimed at reducing the risk of infections, which can exacerbate heart failure. This intervention falls under primary prevention, as it aims to prevent the occurrence of a new health issue (pneumonia) rather than managing an existing condition.

Choice D Reason:
While assessing for edema is important in managing heart failure, it is more of a diagnostic activity rather than an intervention. Tertiary prevention involves interventions to manage and mitigate the effects of an existing disease.