4.1.6: FRAME 6- Evaluate Outcomes
- Page ID
- 90012
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QUESTION: Highlight Text
Scoring Rule: +/-
The nurse is performing discharge instructions to the client. Which of the follow statements from the client indicates to the nurse additional teaching and/or follow-up is needed?
Highlight your answers below.
“I should avoid crowds during cold and flu season.”
“I need to quit smoking again.”
“I am okay to eat foods high in fat and sugar because I burn so many calories during the day.”
“I know there are many things that affect my breathing, including cold weather, high humidity, and allergens.”
“I am going to use my mug at home to ensure I drink at least 8 of them during the day.”
“I should take the prednisone in the morning with my donut and juice.”
Putting It All Together
DEBRIEF
When discharging a client who has been admitted to the hospital multiple times, it is important for the nurse to recognize the level of knowledge and understanding the client has about their disease process, prevention measures, medications, and therapies. Furthermore, nurses must look beyond and help the client identify any barriers that may occur once leaving the hospital or acute care setting. Additionally, the nurse recognizes Stanley’s inability to understand healthy food choices. The muscles of COPD clients may require ten times more calories than someone without COPD (American Lung Association, 2023a). Limiting simple carbohydrates, including table sugar, candy, cake, and regular soft drinks, can help reduce the amount of carbon dioxide produced during the breakdown of these in the body.
Pulmonary rehabilitation is a supervised program that includes exercise training, health education, breathing techniques, and support. Pulmonary rehab is a multidisciplinary approach that improves exercise tolerance, reduces dyspnea, and often leads to improved quality of life (Price & Williams, 2020). Pulmonary rehab has been shown to reduce anxiety and depression, which are linked to an increased risk of COPD exacerbations and poor health outcomes. Individuals with frequent COPD exacerbations generally have a lower quality of life with quicker progression of the disease, reduced mobility, and a more rapid decline in lung function versus those who do not have frequent exacerbations (Price & Williams, 2020).
RECOGNIZING SOCIAL DETERMINANTS OF HEALTH (SDOH)
The goal of the domain, Neighborhood and Built Environment, is to create neighborhoods and environments that promote health and safety. This includes individual home environments as well. Healthy People 2030 focuses on preventing individuals from using tobacco products and helping them quit (TU-01, TU-02). Smoking harms nearly every organ in the body and increases the risk of heart disease, stroke, lung disease, and many types of cancers. Although smoking is widespread among individuals, it is more common in certain groups, including men, American Indians/Alaska Natives, individuals with behavioral health conditions, LGBTQIA+2 individuals, and those with lower incomes and education levels (U.S. Department of Health and Human Services, 2023).
What Do You Think About?
- What additional teaching methods could the nurse use to enhance Stanley’s knowledge?
- Which of Stanley’s SDOH will impact him the most after discharged from the hospital?
- What might be triggering Stanley’s COPD exacerbations at home?
- Identify associations with tobacco use the nurse could incorporate with Stanley’s discharge teaching.