As a nurse caring for a cognitively impaired older adult client, you need to observe for which of the following? (Select all that apply.)

Medicare supplemental insurance, commonly known as Medigap, does not have a Part 8. The options provided seem to be a combination of different parts of Medicare and supplementary insurance.

A. It covers the costs of outpatient services.

Explanation: This statement is generally true, but it is associated with Medicare Part B, which covers outpatient services. Medigap plans can help cover some of the out-of-pocket costs associated with Medicare Part B services.

B. It must be purchased and is a subsidized medical policy.

Explanation: This statement is partially true. Medigap policies must be purchased, but they are not subsidized. Individuals pay private insurance companies for Medigap coverage to help pay for certain costs not covered by Original Medicare (Parts A and B).

C. It covers the costs of speech therapy.

Explanation: This statement is generally true. Medigap plans may cover part or all of the costs associated with Medicare-approved services, including speech therapy.

D. It covers medication costs.

Explanation: This statement is not entirely accurate. Medigap plans do not cover prescription drugs. Coverage for prescription medications is typically provided through Medicare Part D, which is a separate prescription drug coverage plan.

A. Stroke under the chin in a downward motion.
Explanation: Stroking under the chin in a downward motion is not considered a standard technique for managing dysphagia. It's important to focus on strategies that promote safe swallowing and prevent aspiration.

B. Keep pulse oximeter ready at all times.
Explanation: While monitoring oxygen saturation is important in certain situations, having a pulse oximeter ready at all times may not be a routine instruction for feeding a client with dysphagia. Monitoring for signs of distress and ensuring a safe feeding environment are key aspects of care.

C. Avoid rushing the client or force feeding her.
Explanation: Rushing or force-feeding a client with dysphagia can increase the risk of aspiration. It's important to allow the client to eat at their own pace and take adequate time to chew and swallow safely.

D. If facial weakness is present, place food on the impaired side of the mouth.
Explanation: Placing food on the impaired side of the mouth can help compensate for facial weakness and promote more effective chewing and swallowing.

E. Alternate solid and liquid boluses.
Explanation: Alternating solid and liquid boluses can help with the overall coordination of the swallowing process. It can also facilitate the movement of food and liquids through the digestive tract.

F. Have the client sit at 90 degrees during all of oral intake.
Explanation: Ensuring that the client sits at a 90-degree angle during oral intake helps promote an upright position that aids in swallowing and reduces the risk of aspiration.