A home health nurse is caring for an elderly client who has heart failure. Which of the following interventions on the tertiary level of prevention could be included in the care?
Reinforce past teachings on how to read food labels.
Review the daily weights the client has collected since the last home visit.
Remind the client to ask for the pneumococcal vaccine during their next provider appointment.
Auscultate the lungs and assess for edema.
The Correct Answer is B
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.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A: Prevalence Rate
The prevalence rate measures the total number of cases of a disease or health condition in a population at a specific point in time or over a specified period. It is expressed as a proportion of the population. While useful for understanding the burden of disease, the prevalence rate does not provide information on the number of deaths, making it unsuitable for calculating mortality data.
Choice B: Case Fatality Rate
The case fatality rate (CFR) is the proportion of individuals diagnosed with a particular disease who die from that disease within a specified period. It is expressed as a percentage. While CFR provides insight into the severity of a disease, it does not give the overall number of deaths in a population, nor does it specify the age group affected.
Choice C: Age-Specific Mortality Rate
The age-specific mortality rate is the number of deaths in a specific age group per 100,000 population in that age group over a given period. This measure is ideal for calculating the number of deaths among school-age children, as it provides detailed mortality data specific to that age group. By using this rate, the nurse can accurately determine the mortality rate for school-age children in the county.
Choice D: Cause-Specific Mortality Rate
The cause-specific mortality rate is the number of deaths from a specific cause per 100,000 population in a given year. While this measure is useful for understanding the impact of specific diseases or conditions, it does not provide a comprehensive view of mortality across different age groups. Therefore, it is not the best choice for calculating the overall number of deaths among school-age children.
Correct Answer is A
Explanation
Choice A Reason:
Conducting a physical examination is the first step in addressing the employee's concern about hearing loss. This examination allows the nurse to assess the ear for any visible issues, such as earwax buildup, infection, or structural abnormalities. A thorough physical examination can help identify the cause of the hearing loss and determine the appropriate next steps. It is essential to rule out any immediate and easily treatable conditions before proceeding with more specialized interventions.
Choice B Reason:
Irrigating the ear to remove any obstruction, such as earwax, can be an effective treatment for hearing loss caused by cerumen impaction. However, this should only be done after a physical examination confirms that earwax is the cause of the hearing loss. Irrigation without proper assessment can potentially cause harm, especially if there is an underlying infection or perforation of the eardrum.
Choice C Reason:
Advising the client on the use of ear plugs is a preventive measure to protect hearing, particularly in noisy environments. However, this advice does not address the immediate concern of unilateral hearing loss. Ear plugs are more relevant for preventing further hearing damage rather than diagnosing or treating existing hearing issues.
Choice D Reason:
Referring the client to an audiologist is an important step if the initial physical examination does not reveal the cause of the hearing loss or if the hearing loss persists despite initial treatment. Audiologists specialize in diagnosing and treating hearing disorders and can perform comprehensive hearing tests. However, this referral should come after the nurse has conducted a preliminary assessment to rule out any obvious and treatable causes.
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