Which is not connected with the nursing home reform mandated by a ...

[WWatsford]

Which is not connected with the nursing home reform mandated by a 1987 law?
 
  a. RAI
  b. HIPAA
  c. MDS
  d. UG

Question 2

An older man who has hyperuricemia complains of severe pain in the right ankle. Which instructions should the nurse include in patient teaching to enhance the action of the medication the patient takes for his condition? (Select all that apply.)
 
  a. Avoid dehydration by drinking water.
  b. Take aspirin when joints are red and hot.
  c. Comply with antihypertensive diuretic regimen.
  d. Avoid game meat, asparagus, and alcohol.

[SAUXC]

Answer to Question 1

B

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A Incorrect. The Resident Assessment Instrument (RAI) must be completed for all residents receiving Medicare or Medicaid.
B Correct. The Health Insurance Portability and Accountability Act was passed in 1996 and mandates privacy practices.
C Incorrect. The Minimum Data Set (MDS) is a portion of the RAI that is used to collect definitive information on the patient's functioning.
D Incorrect. Utilization guidelines (UGs) govern the nurse's assessment of trigger problems according to the resident assessment protocols (RAPs) of the MDS.

Answer to Question 2

A, B, D
Because this individual exhibits an acute attack in the ankle from hyperuricemia, the goal of therapy is to prevent another attack. To decrease uric acid production, the prophylactic medica-tion of choice for gouty arthritis is colchicine (Colsalide). To enhance the action of this medica-tion and to further reduce this patient's risk of another attack, the nurse instructs the patient to avoid game meat and asparagus, because they contain purine, and to avoid alcohol, because it increases uric acid production. The nurse instructs the patient to drink 2 liters of water daily to facilitate uric acid excretion and to prevent the crystallization of uric acid in the renal tubules. The nurse also instructs this individual to avoid aspirin because it increases the risk of an acute attack and counteracts the benefit of uric acid prophylaxis. Antihypertensive therapy helps re-duce the risk of another attack, but when diuretic agents are used for antihypertensive therapy, the potential benefit for gout prophylaxis is blunted because diuretics increase the risk of gouty attacks.