A nurse is planning for the discharge of a client who has advanced lung cancer. The client's partner tells the nurse that they plan to manage the client's care at home but has concerns about leaving the client alone to attend to personal errands. Which of the following services should the nurse suggest?

Rationale:

A. This option is incorrect because finding a support group is outside the occupational therapist’s scope of practice. Social workers or case managers are typically responsible for connecting clients to community resources, emotional support, and advocacy services. While occupational therapists may provide some psychosocial support during therapy, arranging support group access is not their primary role.

B. This option is correct because difficulty grasping eating utensils is a problem related to fine motor skills, hand strength, and coordination, all of which fall within the occupational therapist’s scope. Clients with myasthenia gravis often experience muscle weakness, especially in the hands and arms, which can interfere with activities of daily living (ADLs) such as eating, grooming, dressing, and writing. The occupational therapist can assess the client’s functional abilities, recommend adaptive devices (e.g., built-up utensils, splints, or ergonomic tools), and provide exercises and strategies to improve independence and maintain safety. Communicating this information ensures that the occupational therapist can tailor interventions to the client’s specific needs.

C. This option is incorrect because dysarthria, or difficulty with speech articulation, is the domain of a speech-language pathologist. Speech therapists evaluate and treat communication and swallowing disorders, not fine motor skill deficits.

D. This option is incorrect because generalized weakness affecting ambulation is primarily addressed by a physical therapist. Physical therapy focuses on mobility, gait training, strengthening of large muscle groups, balance, and fall prevention. While occupational therapy may address some aspects of functional mobility, their main focus is on enabling the client to perform self-care and instrumental activities of daily living independently.

Rationale:

A. This option is correct because applying moisturizing lotion after bathing helps maintain skin integrity, prevents dryness and cracking, and reduces the risk of pressure injuries. Proper skin care is a key preventive measure for clients who are immobile.

B. This option is incorrect because massaging bony prominences is not recommended; it can actually cause tissue damage and increase the risk of pressure injury. Instead, gentle repositioning and pressure-relief techniques should be used.

C. This option is incorrect because maintaining the head of the bed at a 45° angle increases pressure on the sacral area, heightening the risk for pressure injuries. The head of the bed should generally be kept at 30° or less when possible to reduce shear and pressure on bony prominences.

D. This option is incorrect because contact isolation is not a preventive measure for pressure injuries. It is used for clients with infectious conditions to prevent transmission, not for immobility-related skin protection.