Chapter 3 Community and Home Care Flashcards
The nurse should be aware that a statistic widely used to compare the health status of different populations would be the:
A. Incidence of specific infections such as acquired immunodeficiency syndrome (AIDS) and tuberculosis.
B. Infant mortality rate.
C. Maternal morbidity rate.
D. Incidence of low-birth-weight infants.
B. City, county, and state health departments provide annual reports of births and deaths. Maternal and infant death rates are particularly important because they reflect health outcomes that may be preventable. Incidence of specific infections, maternal morbidity rate, and incidence of low-birth-weight infants may be targets of research studies, but maternal and infant mortality rates are particularly important.
Which health care service represents the primary level of prevention? A. immunizations B. breast self examination C. home care for high risk pregnancies D. blood pressure screening
A. Primary prevention involves health promotion and disease prevention activities to reduce the occurrence of illness and enhance general health and quality of life. This includes immunizations, using infant car seats, and health education to prevent tobacco use. Breast self-examination is an example of secondary prevention, which involves early detection of health problems. Home care for a high risk pregnancy is an example of tertiary prevention. This level of care follows the occurrence of a defect or disability. Blood pressure screening is an example of secondary prevention. It is a screening tool for early detection of a health care problem
What is the primary difference between hospital care and home health care?
A. Home care is routinely delivered continuously by professional staff.
B. Home care is delivered on an intermittent basis by professional staff.
C. Home care is delivered for emergency conditions.
D. Home care is not available 24 hours a day.
B. Home care generally is delivered on an intermittent basis by professional staff. The primary difference between health care in a hospital and home care is the absence of the continuous presence of professional health care providers in a client’s home. Generally home health care entails intermittent care by a professional who visits the client’s home for a particular reason and provides care on site for periods shorter than 4 hours at a time.
Which situation would be considered safe by a nurse who is making a home visit?
A. A group of teens is sitting on the stairs in front of the client’s apartment.
B. Parking is only possible 3 blocks from the client’s house because no space is available in front of the house
C. The family dog is on a chain in the front yard
D. The door of the home is open when the nurse arrives.
C. Home care nurses should not enter a yard that has an unrestrained dog. While walking to the client’s home, nurses should not walk near groups of strangers who are in doorways or alleys. Home care nurses should park and lock their cars in a safe place that is visible from the street and the client’s home. The home should not be entered if the nurse has any safety concerns such as an open front door.
What is a limitation of a home postpartum visit?
A. The nurse’s ability to teach is limited by many distractions.
B. Identified problems cannot be resolved in the home setting.
C. Necessary items for infant care are not available.
D. Home visits to different families may require the nurse to travel a great distance.
D. One limitation of home health visits is the distance the nurse must travel between clients. Distractions at the home, problems that cannot be resolved in the home, and unavailable items for infant care are factors that should be addressed through a phone interview before the visit
What would a breastfeeding mother who is concerned that her baby is not getting enough to eat find most helpful and most cost effective on the day after discharge?
a. Visiting a pediatric screening clinic at the hospital
b. Placing a call to the hospital nursery “warm line”
c. Calling the pediatrician for a lactation consult referral
d. Requesting a home visit
B. Warm lines are telephone lines offered as a community service to provide new parents with support, encouragement, and basic parenting education. Visiting a pediatric screening clinic, calling the pediatrician for a referral, and requesting a home visit would not necessarily be cost-effective.
Which area would be appropriate to include in a physical assessment of the home?
a. Bathtub, toilets, sinks, countertops, inside china cabinet drawers
b. Baby’s bed, changing table, baby’s clothes, inside diaper bag, inside keepsake box
c. Bedroom closets, inside jewelry boxes, under beds
d. Electrical wall outlets, telephones, bathroom sink and faucets, stove, and refrigerator
D.Physical assessment of the home environment is an essential element of the home care assessment. The major areas of the home environment assessment include physical features of the home, access to the home, sanitary conditions, the presence of utilities (phone, electricity, and plumbing), safety features, and access to transportation and emergency support. The purpose of a physical assessment does not include accounting for the client’s possessions or looking inside drawers
When providing health education to the client, the nurse understands that an example of the secondary level of prevention is:
A. Approved infant car seats.
B. Breast self-examination (BSE).
C. Immunizations.
D. Support groups for parents of children with Down syndrome.
B. BSE is an example of secondary prevention, which includes health screening measures for early detection of health problems. Infant car seats and immunizations are examples of primary prevention. Support groups are an example of tertiary prevention, which follows the occurrence of a defect or disability (e.g., Down syndrome).
A health care service representing the tertiary level of prevention includes:
A. Stress management seminars.
B. Childbirth education classes for single parents.
C. A breast self-examination (BSE) pamphlet and teaching.
D. A premenstrual syndrome (PMS) support group.
D. A PMS support group is an example of tertiary prevention, which follows the occurrence of a defect or disability (e.g., PMS). Stress management seminars are a primary prevention technique for preventing health care issues associated with stress. Childbirth education is a form of primary prevention. BSE information is a form of secondary prevention, which is geared toward early detection of health problems.
A primipara delivered a 7-pound, 3-ounce baby girl 10 days ago. During a home visit the nurse discovers that the baby has lost 11 ounces since birth. She suspects that the woman may be having difficulty with breastfeeding. The nurse inquires how breastfeeding is proceeding. The woman replies, “I don’t think my milk is going to come in. My breasts are too big. I’m going to wait a few more days and then try to breastfeed again.” The nurse asks the woman if she is bottle feeding the baby and how much formula the baby is taking every day. The woman replies, “Oh, I don’t want to bottle-feed the baby. I’m just going to wait until my milk comes in.” On the basis of this information, what nursing diagnosis would take priority in planning care? A. pain B. ineffective coping C. caregiver role strain D. deficient knowledge
D. The woman is displaying a lack of knowledge about proper nutrition for her newborn. The baby has lost almost 10% of her body weight and is not receiving any form of intake. Furthermore, the woman has incorrect, preconceived notions about milk production and breastfeeding. Although the woman may be experiencing pain, it is not indicated in the information provided. Although the woman may be experiencing ineffective coping, it is not indicated in the information provided. The woman appears to show signs of role strain related to being a first-time mother. However, this is not the priority.
What is NOT a trend in the delivery of health care in the United States?
a. Greater emphasis has been placed on curing disease and disability than on preventing them.
b. Hospital stays for many conditions have been shortened.
c. Acute care increasingly is provided through home-based services.
d. Hospital-based nurses increasingly are involved in follow-up care after discharge.
A. Preventative care is now emphasized. Hospitalization has been shortened to reduce cost. Acute care increasingly is provided at home. Nurses now are more involved in postdischarge follow up care.
Practices such as providing recommended immunizations, infant car seats, and school health education are part of A. Primary preventative care B. secondary preventative care C. tertiary preventative care D. primordial preventative care
A. These activities are designed to improve general health and the quality of life, which is the focus of primary preventative care, but not secondary, tertiary, or primordial preventative care.
Providing various methods of health screening for early detection of disease is part of A. preventative care B. secondary preventative care C. teritiary preventative care D. primordial preventative care
B. Health screening for early detection of health problems is part of secondary preventative care.
Providing treatment and rehabilitation for people who have developed disease is part of A. primary preventative care B. secondary preventative care C. tertiary preventative care D. primordial preventative care
C. Tertiary preventative care is the treatment or rehabilitation of those who have disease.
Clinical integration of services along the perinatal continuum of care:
a. Focuses on results, not client or provider satisfaction.
b. Is not concerned with cost containment.
c. Is designed to improve services and care outcomes.
d. Focuses on the individual client.
C. Clinical integration provides health promotion and disease prevention interventions along the perinatal health continuum. Clinical integration is concerned with client, payer, and provider satisfaction. Clinical integration is also designed to reduce costs. Clinical integration is focused on populations rather than individuals. It is designed to improve services and care outcomes.