Home Health Nursing
Which are the three primary types of home care services?
Private duty Home healthcare Personal care and companionship
Identify the home care services that can be performed by the Registered Nurse (RN), Licensed Vocational Nurse (LVN/LPN), or Unlicensed Assistive Personnel (UAP). Answer options can be used more than once.
RN: Vital signs Catheter insertion Bathing and grooming Medication administration Oral hygiene LVN: Vital signs Catheter insertion Bathing and grooming Medication administration Oral hygiene UAP: Vital signs Bathing and grooming Oral hygiene
Which statement is true regarding the benefits of home care service use?
Medicare promotes the use of home healthcare services as an alternative to inpatient hospitalization.
The client expresses the desire to enhance independence with health and activities of daily living (ADLs). Based on this information, which primary nursing diagnosis would be a priority?
Readiness for enhanced self-care
Based on the client's history, the highest priority nursing diagnosis is infectionimpaired tissue integrityimmunocompromised system related to invasive proceduremalnutritionsigns of infection .
impaired tissue integrity signs of infectino
Home healthcare use
increasing a home increased
The primary care provider prescribes vancomycin intravenous (IV) to treat the infection. What health teaching will the nurse include for the client prior to medication administration? Select all that apply.
"Blood will be drawn frequently to measure drug levels to make sure they are effective in treating your infection." "Please let me know if you have any nausea or diarrhea as this may occur when taking this drug." "We will be carefully monitoring your kidney function while on this medication." "I will be monitoring you for signs of infection, which includes taking your temperature and assessing your wound."
According to the Institute for Healthcare Improvement (2018), what are the principles that guide safety in the home? Select all that apply.
A robust learning and improvement system Self-determination in all aspects of care Effective team-based care and care coordination Organizations must create and maintain a safety culture
Home care nursing referrals come from which sources? Select all that apply.
Case managers Social services Therapy services Client requests Healthcare providers
For each assessment finding, indicate if it is consistent or not consistent with signs of an infection.
Consistent: Greenish-yellow wound drainage Red, swollen, warm to touch skin T 100.6°F (38.2°C) Methicillin-resistant staphylococcus aureus (MRSA) Not Consistent: RR 18 BP 128/76
Which home health claims are suitable for Medicare coverage? Select all that apply.
Dr. Chan has signed a care plan certifying that services are medically necessary and is willing to certify that the client was evaluated face-to-face within 90 days prior to the start of care. Mr. Rodriguez needs skilled nursing care on an intermittent basis (less than 7 days per week but at least once every 60 days) and continuing occupational therapy. Mrs. Roberts is homebound and leaving home requires considerable effort, including the need for a personal assistant and the use of a wheelchair.
For each assessment finding, select whether the client's statement indicates if their condition has improved or not improved.
Improved: Client reports mild pain in left lower leg at 2/10 on a pain scale. Client's left lower leg wound measures 1x1cm, minimal redness, and without drainage. Client's oral temperature is 99.2 F and 98.4 F at the last two home visits. Not Improved: Client reports having diarrhea 4-5 times a day for the last 3 days. Client reports difficulty urinating stating, "I have peed less and less the last 3 days."
Indicate if the nursing actions listed below are indicated, contraindicated, or nonessential for the client's care at this time.
Indicated: Place the client on contact precautions. Observe and report signs of infection such as redness, warmth, discharge, and increased body temperature. Initiate IV access for prescribed drug therapy. Contraindicated: Apply a cold compress to the wound site. Take a wound culture every shift to determine if the area is improving. Nonessential: none
The nurse works as a home care nurse. Review the nurse's note and highlight the assessment findings that require follow up by the nurse.
MRSA foul smelling and greenish-yellow red, swollen, and warm to touch. Pain is reported 6/10 on pain scale. BP 130/76, P 102, RR 18, T (oral) 100.6°F (38.2°C)
Which nursing actions support the client's ability to enhance self-care based on functional abilities? Select all that apply.
Support the client's awareness that enhanced self-care is an attainable and positive life goal. Promote social support through facilitation of family involvement or through support groups. Perform a self-care assessment to identify baseline functional ability. Help the client identify strategies to enhance self-care and reduce barriers.
What types of funding sources are available to clients to help pay for home care services? Select all that apply.
Workers' compensation Long-term care insurance Private pay Medicare Private health insurance