4.4.5: FRAME 5- Take Action
- Page ID
- 90032
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It is post-op day 5, and Jacklyn has made great progress in her physical, emotional, and mental post-operative recovery. Two days ago, Jacklyn started in-patient Cardiac Rehab where she met other individuals who have also recently undergone cardiac surgeries and procedures. Jacklyn has completed one day at Cardiac Rehab and has quickly formed a bond with one of the cardiac nurses who lost their spouse just 6 months ago. The telemetry nurse caring for Jacklyn today is reviewing her chart before giving morning medications.
QUESTION: Multiple Choice
Scoring Rule: 0/1
The nurse enters the client’s room to see Jacklyn sitting in the chair, eating breakfast. The nurse sees Jacklyn’s nasal cannula laying on the bed next to her. The nurse asks Jacklyn how she is feeling this morning, and she states, “I’m feeling better each day, it is just so hard to eat with that thing stuck up your nose, so I took it off…I hope that is okay.”
What action will nurse take next?
- Put the nasal canula back on the client
- Tell Jacklyn if she becomes short of breath to put it back on
- Check Sp02
- Educate Jacklyn on the importance of keeping things on until the nurse says it is okay to take off
Putting It All Together
DEBRIEF
Cardiac rehab is a specific type of therapy focused on clients who have had a recent heart attack, heart conditions such as coronary artery disease (CAD), heart failure (HF), peripheral artery disease (PAD), or recent heart procedures/surgeries. Additionally, there are many other types of therapies to promote better health outcomes for clients after major surgery. These therapies include a multidisciplinary team that may include providers, nurses, exercise specialists, dieticians, nutritionists, and many others. Rehabilitation measures focus on holistic approaches to promoting independence and healthy living. This includes clients' physical, mental, and emotional support as they recover. It is evident that Jacklyn is already seeing a positive impact from cardiac rehab, especially from a mental and emotional supportive aspect. Developing a sense of community for clients to ensure they are not alone can provide significant positive and forward progression in their recovery.
The client's chart, including nursing notes, lab values, and vital signs, all indicate improvement in Jacklyn's oxygenation and breathing status. Therefore, it would be appropriate for the nurse's next action to see what the client's Sp02 is to assess the client's ability to oxygenate without supplemental oxygen. If the SpO2 is adequate and the client is not showing signs of distress, keeping the oxygen off the client would be appropriate. Additionally, this forward progress will help support Jacklyn's mental and emotional states as it will bring positive thoughts forward as she is not reliant on medical therapies as much.
RECOGNIZING SOCIAL DETERMINANTS OF HEALTH (SDOH)
Transportation is an important SDOH in rural communities. The availability of reliable transportation impacts an individual’s ability to access appropriate and well-coordinated healthcare, purchase nutritious food, and otherwise care for themselves. Rural populations have a greater need for transportation services to maintain their health and wellbeing. Populations most at risk include older adults, people with disabilities, low-income individuals and families, veterans, and people with special healthcare needs who require additional assistance to access healthcare. Communities that provide transportation services to support access to rural healthcare benefit healthcare providers by decreasing inappropriate use of EMS services, improving utilization of healthcare services, decreasing no-show rates, and increasing access to health-supporting services. Transportation as a community-based service can allow the elderly and people with disabilities to live successfully in a community rather than entering a long-term care facility or leaving the community (Rural Health Information Hub, 2022).
What Do You Think About?
- What other measurements or assessment pieces would the nurse look for to identify forward/positive progression from cardiac rehab?
- Identify resources in the community that may provide transportation to prescribed therapies in your local community.
- Identify 5 primary factors that may limit Jacklyn’s ability to be adherent to her cardiac rehab schedule.