A case manager is performing discharge planning for a client who experienced a traumatic leg amputation and has a new prosthesis. Which of the following assessments should the nurse identify as the priority?
Ask whether the client's insurance will cover home health services
Determine whether the client is eligible to go to a skilled nursing facility.
Collaborate with a prosthetist to teach the client about care of the prosthesis.
Evaluate the client's home environment.
The Correct Answer is D
A. Ask whether the client's insurance will cover home health services: While financial coverage is important for ongoing care, it is not the immediate priority. Assessing physical and environmental safety takes precedence to ensure a smooth and safe transition home.
B. Determine whether the client is eligible to go to a skilled nursing facility: This is a relevant consideration for continued care but does not directly address the client’s immediate post-discharge needs regarding their ability to function safely at home with the prosthesis.
C. Collaborate with a prosthetist to teach the client about care of the prosthesis: Education on prosthesis care is essential but should occur after ensuring that the home environment is suitable for mobility, safety, and prosthesis use.
D. Evaluate the client's home environment: This is the priority because safety and accessibility of the home are critical for a client with a new prosthesis. Identifying barriers such as stairs or narrow doorways helps prevent injury and promotes independence.
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Related Questions
Correct Answer is C
Explanation
A. Community organizations: Community organizations fall under the “social and community context” domain of social determinants of health. They influence social support, civic participation, and interpersonal relationships, but are not considered a component of the physical environment.
B. Level of education: Level of education is categorized under the “education access and quality” domain. It encompasses early childhood education, literacy, and higher education, which are important for long-term health outcomes but not part of the built environment.
C. Quality of housing: Quality of housing is a key element of the “neighborhood and built environment” domain. It directly affects physical health and safety through exposure to hazards such as lead, mold, and inadequate heating or ventilation. Poor housing conditions are linked to higher rates of chronic illness and injury.
D. Health insurance coverage: Health insurance coverage is part of the “health care access and quality” domain. It affects an individual’s ability to seek medical services but is unrelated to the physical or structural aspects of a neighborhood’s environment.
Correct Answer is A
Explanation
A. Determine each member's role in the family: This method directly assesses how the family functions as a unit, including dynamics such as communication, decision-making, hierarchy, and caregiving responsibilities—core elements of the family systems approach.
B. Review the Healthy People objectives for family health: While useful for setting public health goals, this approach is broad and population-focused and does not provide specific insights into the functioning of an individual family unit.
C. Complete a three-generation genogram of the family: A genogram maps biological and health histories across generations, which helps with identifying patterns of disease or risk but does not specifically evaluate family functioning or roles.
D. Conduct a windshield survey of the family's community: A windshield survey helps assess community-level environmental factors but does not give information about internal family dynamics or functioning as emphasized in the family systems approach.
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