Author Question: An older woman has diabetes mellitus and requires hemodialysis for renal failure. She is discharged ... (Read 122 times)

Bob-Dole · **on:** Jul 11, 2018

An older woman has diabetes mellitus and requires hemodialysis for renal failure. She is discharged to home to recover from a sternal wound infection and coronary artery bypass graft surgery (CABG). A home care nurse will provide wound care.

Which of the following is the major justification for the complete and accurate documentation of this older adult's care? a. Requires complex health care
b. Has needs in multiple settings
c. Is at risk for iatrogenic problems
d. Has significant health care expenses

Question 2

Which feature of life in sub-Saharan Africa should the nurse use to plan health care for older adults?

a. Human immunodeficiency virus (HIV) is an epidemic.
b. The majority of the population are women.
c. Climate is hot and arid.
d. Clean water is scarce.

CAPTAINAMERICA · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

A
The major reason that documentation of this patient's health care must be accurate and complete is that she has complex health care needs in multiple settings and experiences a high risk for ia-trogenic problems and high reimbursement expenses. The duration of her care is likely to be lengthy; the sternal wound infection after CABG is serious because of the potential for sternal osteomyelitis. In addition, individuals with diabetes are at high risk for infection and are slow to heal.
The complexity of her care includes receiving care in multiple settingsat home, at di-alysis, and in primary care for postdischarge follow-up care. For an older adult with diabetes, coronary artery disease, renal failure, and a serious infection, each facet of her health care de-pends on complete and accurate data on the other aspects of her care to help her achieve optimal health and wellness. This older adult is at risk for iatrogenic problems because of the complexity of her care. Each type of care, each illness or condition, and each setting exposes this older adult to a separate set of risks. In addition, individuals with diabetes can have peripheral neuropathies that increase the risk for falls and injuries. This older adult incurs health care expenses dealing with complex health care requirements including a recent hospital stay for surgery and compli-cated by an infection, ongoing needs for hemodialysis, and home care. Because much of the care is nurse driven, documentation is the basis for which reimbursement is provided.

Answer to Question 2

B

Feedback
A Incorrect. The spread of HIV in this region is a public health concern.
B Correct. In a developing area such as sub-Saharan Africa, the majority of older adults will be women.
C Incorrect. The climate is a geographical concern.
D Incorrect. The lack of clean water is another public health concern.