A nurse is preparing to discharge a client who is postoperative following a total hip arthroplasty. Which of the following equipment should the nurse ensure that the client has available at home prior to discharge?

Answer: D. A client whose medications to manage Parkinson's disease are no longer effective.

Rationale:

A) A client who is newly diagnosed with type 1 diabetes mellitus and cannot afford insulin:

While this client has a significant medical issue, the primary concern here is financial rather than palliative. Palliative care focuses on providing relief from symptoms and improving quality of life for those with serious illnesses. Addressing the client's financial issues might involve social services or community resources rather than palliative care.

B) A client who has Meniere's disease and cannot safely ambulate due to vertigo:

Meniere's disease, while debilitating, may not necessarily require palliative care unless the symptoms are severely impacting the client's quality of life in a way that is not manageable with current treatments. Palliative care could be considered if the disease is severely limiting function and other supportive care is needed.

C) A client who had a stroke and cannot eat or drink without choking:

This client is experiencing a significant functional impairment due to the stroke, which might benefit from rehabilitative services rather than palliative care. Palliative care would be more appropriate if the client's condition is progressive, severe, and not responsive to treatment, leading to a focus on comfort and quality of life.

D) A client whose medications to manage Parkinson's disease are no longer effective:

When medications for Parkinson's disease are no longer effective, the client may be experiencing advanced symptoms and a decline in quality of life. Palliative care can provide symptom management, support, and enhance the client's quality of life when conventional treatments are no longer effective in controlling symptoms.

Choice A rationale:

Providing pin care when the client is 4 hours postoperative is not appropriate. The client has just undergone skeletal traction placement, and pin care is usually initiated after 24 hours to allow for initial wound healing.

Choice B rationale:

Removing the weights from the traction while repositioning the client in bed is unsafe and not recommended. The weights should remain in place to provide continuous traction and alignment for the fractured hip.

Choice C rationale:

Assessing the client's circulation every 4 hours is essential to monitor for any signs of impaired circulation, such as swelling, pallor, or decreased pulses. Early detection of circulatory compromise is critical to prevent complications like compartment syndrome.

Choice D rationale:

Requesting the client to perform ankle exercises on the affected extremity is not appropriate after skeletal traction placement. Ankle exercises could disrupt traction and hinder the healing process of the fractured hip.