community health nurse is developing a plan of care for an older adult client who has type 2 diabetes mellitus and lives independently in a rural area. Which of the following interventions should the nurse include?

Suggest that the client attend adult day care three times per week.

Review assisted living accommodations with the client.

Discuss a long-term care referral for the client with the provider.

Instruct the client about the use of telehealth services.

Answer and Explanation

The Correct Answer is D

A. Suggest that the client attend adult day care three times per week: While adult day care can provide socialization opportunities and supervision for older adults, it may not be suitable for all clients, especially those who are still independent and prefer to live in their own homes. Additionally, attending adult day care may not directly address the client's diabetes management needs.
B. Review assisted living accommodations with the client: Assisted living accommodations are typically considered for individuals who require assistance with activities of daily living (ADLs) or who can no longer live independently. Since the client in this scenario lives independently, reviewing assisted living accommodations may not be appropriate at this time.
C. Discuss a long-term care referral for the client with the provider: Long-term care referrals are generally reserved for individuals who require ongoing assistance with ADLs and medical care that cannot be adequately provided in a home setting. Since the client is currently living independently and managing their diabetes, a long-term care referral may not be necessary.
D. Instruct the client about the use of telehealth services: This is the most appropriate intervention for the client in a rural area who may have limited access to healthcare resources. Telehealth services can provide remote monitoring, education, and support for managing diabetes while allowing the client to remain in their home environment. This intervention promotes independence and supports the client's ability to manage their condition effectively while living in a rural area.

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Correct Answer is A

Explanation

Answer: A

Rationale: A) "Empty your ostomy pouch when it is half full.": This instruction is essential to prevent the pouch from becoming too heavy, which can cause leakage or discomfort. Regular emptying also helps maintain the integrity of the pouching system and prevents leaks.

B) "Notify the provider if your stoma becomes pink and moist.": While it's crucial to monitor the stoma's appearance for signs of complications, a pink and moist stoma typically indicates healthy tissue. This instruction may cause unnecessary concern for the client.

C) "Use a moisturizing soap to cleanse your stoma.": Moisturizing soap is not recommended for stoma cleansing, as it may leave a residue that interferes with the pouch's adhesion and can lead to skin irritation. Instead, the client should use warm water and a mild, non-moisturizing soap.

D) "Apply sterile gloves when changing your ostomy pouch.": While hand hygiene is essential when managing an ostomy, sterile gloves are not necessary for routine pouch changes. Clean, non-sterile gloves or thorough handwashing with soap and water are sufficient to prevent infection.

A. Attach a dosimeter to the client's gown. B. Strain the client's urine. C. Limit each of the client's visitors to 2 hr per day. D. Instruct visitors to stay 1 m (3.3 feet) away from the client.

Correct Answer is D

Explanation

A. Attach a dosimeter to the client's gown: A dosimeter measures the radiation dose received by the wearer over a period of time. While healthcare providers and personnel working closely with the client during brachytherapy may wear dosimeters, attaching one to the client's gown is not a standard practice.
B. Strain the client's urine: Straining the client's urine is not directly related to the care required for a client undergoing brachytherapy. The primary focus of care during brachytherapy is to minimize radiation exposure to others and promote the client's comfort and safety.
C. Limit each of the client's visitors to 2 hr per day: While it may be appropriate to limit the duration of visits to reduce the potential radiation exposure of visitors, the specific time limit of 2 hours per day is not standard and should be determined based on individual circumstances and institutional policies.
D. Instruct visitors to stay 1 m (3.3 feet) away from the client: This intervention is appropriate because it helps minimize radiation exposure to visitors. Maintaining distance from the client reduces the risk of radiation exposure to others while still allowing for social interaction and support during the client's treatment.

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community health nurse is developing a plan of care for an older adult client who has type 2 diabetes mellitus and lives independently in a rural area. Which of the following interventions should the nurse include?

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