The nurse instructs the unlicensed assistive personnel to feed an ...

[Metfan725]

The nurse instructs the unlicensed assistive personnel to feed an older adult. If the nurse is unable to observe feeding directly, which action should the nurse use to assess the older adult's risk for aspiration immediately following feeding?
 
  a. Note food volume eaten
  b. Observe skin color
  c. Inspect for pocketing
  d. Monitor for bradypnea

Question 2

Which statement is not true about case management and care management for older adults?
 
  a. A case manager works for a health care system to save time and money.
  b. Care managers are usually paid from public agencies such as the Area Agency on Aging.
  c. One nurse can perform case management and care management.
  d. The Outcomes-Based Quality Improvement system is designed to evaluate the expected benefit of an intervention.

[Joy Chen]

Answer to Question 1

C

Feedback
A Incorrect. The amount of food consumed by an older adult is unrelated to the risk of aspiration so noting the amount of food eaten is unsuitable for detecting a risk for aspiration.
B Incorrect. An alteration in circulation as evidenced by a change in skin color can be a late indicator of aspiration. Thus a change in skin color can indicate the presence of aspiration, but the older adult with a change in skin color is not nec-essarily at risk for aspiration.
C Correct. The nurse is able to assess the risk for aspiration by assessing the adult for pocketing, residual accumulations or pockets of food in the mouth, which the older adult can aspirate after the meal is complete. If food is found in the mouth, the nurse removes it and evaluates the current plan of care.
D Incorrect. The nurse monitors for tachypnea as an indicator of aspiration; how-ever, tachypnea does not indicate a risk for aspiration.

Answer to Question 2

B

Feedback
A Incorrect. This is a true statement.
B Correct. Care managers are rarely paid through the AAA or similar agencies; they are usually paid privately and sometimes through Medicare or Medicaid.
C Incorrect. This is a true statement.
D Incorrect. This is a true statement; the aspects measured are known as efficacy, effectiveness, and efficiency.