A home health nurse is providing teaching to a client and their family about hospice care. Which of the following information should the nurse include in the teaching?

Choice A reason: The anthrax vaccine is ineffective following direct anthrax exposure is not a correct piece of information to include in the protocol. The anthrax vaccine can provide some protection against anthrax if given before exposure, but it cannot prevent or treat anthrax infection after exposure¹.

Choice B reason: Manifestations of anthrax infection appear within 3 days of exposure is not a correct piece of information to include in the protocol. The incubation period of anthrax varies depending on the route of exposure, but it can range from one day to several weeks. Inhalation anthrax usually has an incubation period of one to six days, but it can be longer².

Choice C reason: Prophylactic treatment should be provided to clients for 10 days following exposure to anthrax is not a correct piece of information to include in the protocol. Prophylactic treatment, or post-exposure prophylaxis (PEP), is the use of antibiotics to prevent anthrax infection in people who have been exposed to anthrax spores but do not have symptoms. PEP should be given for at least 60 days, or until the person receives three doses of the anthrax vaccine³.

Choice D reason: Ciprofloxacin should be administered to asymptomatic clients who were directly exposed to anthrax is a correct piece of information to include in the protocol. Ciprofloxacin is one of the antibiotics recommended by the CDC for PEP of anthrax. It can prevent anthrax infection in people who have inhaled anthrax spores but do not have symptoms. Ciprofloxacin should be given as soon as possible after exposure and continued for 60 days, or until the person receives three doses of the anthrax vaccine..

Choice A: The client’s insurance provides coverage for palliative care

This option is incorrect. While insurance coverage for palliative care is important, it is not a qualifying criterion for hospice care. Hospice care eligibility is primarily based on the patient’s medical condition and prognosis, not on insurance coverage.

Choice B: The client has declined additional life prolonging treatments

This option is correct. One of the key criteria for hospice care is that the patient must choose palliative care (comfort care) over curative treatments. This means the patient has decided to stop treatments aimed at prolonging life and instead focus on quality of life and symptom management.

Choice C: The client requires inpatient care due to lack of a caregiver

This option is incorrect. While the need for inpatient care can be a factor in the type of hospice services provided, it is not a criterion for qualifying for hospice care. Hospice care can be provided in various settings, including the patient’s home, regardless of caregiver availability.

Choice D: The client has documentation stating he has less than 12 months to live

This option is incorrect. The standard criterion for hospice care is a prognosis of six months or less to live if the disease follows its usual course. Documentation stating a life expectancy of less than 12 months does not meet the hospice eligibility requirement.