Author Question: The nurse is providing discharge instructions to an elderly client going home after having a total ... (Read 41 times)

tingc95 · **on:** Jul 22, 2018

The nurse is providing discharge instructions to an elderly client going home after having a total knee replacement. The nurse should include which of the following to help prevent the development of a thrombosis or pulmonary embolism?

1. Ensure adequate rest periods and limit ambulation
2. Place pillows under the knees when in bed
3. Limit fluids
4. Continue with leg exercises and use compression stockings

Question 2

The manager of a small clinic has cross-trained the nurses not only to provide basic nursing care, but also to perform ECG testing, phlebotomy, and some respiratory therapy interventions. This clinic is an example of which delivery model?

1. Managed care
2. Case management
3. Client-focused care
4. Critical pathways

Joy Chen · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

4. Continue with leg exercises and use compression stockings

Rationale:
A client being discharged after having orthopedic surgery is at increased risk for pulmonary embolism. The nurse should instruct the client to continue with leg exercises and use compression stockings to reduce the risk of deep vein thrombosis formation. The client should be encouraged to ambulate, avoid placing pillows under the knees, and be well hydrated unless another physiological condition exists that would necessitate a fluid restriction.

Answer to Question 2

3. Client-focused care

Rationale:
Client-focused care is a delivery model that brings all services and care providers to the client. Activities provided by auxiliary personnel (physical therapy, respiratory therapy, ECG testing, and phlebotomy) are moved close to the client, thereby decreasing the number of personnel involved and the number of steps to get the work done. Managed care focuses on cost-effective, quality care which results in decreased costs and improved outcomes. Case management is a way to integrate health care services for individuals or groups and involves multidisciplinary teams that assume collaborative responsibility for planning, assessing needs, and coordinating, implementing, and evaluating care. Critical pathways are used to track the client's progress in case management.