5.1.6: FRAME 6- Evaluate Outcomes
- Page ID
- 90243
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CORRECT Answer
Question Type: Highlight Text
Scoring: +/-
NCSBN Item Type and Scoring: https://www.ncsbn.org/public-files/p...main_stage.pdf
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?
“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”
RATIONALE
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 that is 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 oftentimes 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. In general, clients who have frequent COPD exacerbations have a lower quality of life with quicker progression of the disease, reducing mobility and a more rapid decline in lung function verses those who do not have frequent exacerbations (Price & Williams, 2020).
FOCUSED GUIDE
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 diseases, and many types of cancers. Although smoking is widespread amongst individuals, it is more common in certain groups including men, American Indians/Alaska Natives, individuals with behavioral health conditions, LGBT individuals, and those with lower incomes and education levels (U.S. Department of Health and Human Services, 2023).
When clients are entering back into their social norms after being discharged from the hospital, it is important for them to recognize their associations with their tobacco use, especially those clients who are wishing to quit. Allowing clients to begin to identify these associations while still in the hospital will aid in their success upon discharge. Nurses should recognize the willingness of clients and stimulate conversations with clients to begin the recognition process. Once the associations with tobacco are identified, the nurse can assist the client with mitigation strategies, distractions, or alternative replacements.