Question

The home health nurse is planning for the day's visits. Which client should be seen first? A. The 78-year-old who had a gastrectomy 3 weeks ago with a PEG tube B. The 5 -month-old discharged 1 week ago with pneumonia who is being treated with amoxicillin liquid suspension C. The 50-year-old with MRSA being treated with Vancomycin via a PICC line D. The 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter

Short answer

Answer: The home health nurse should visit the clients in the following order: 1. The 50-year-old with MRSA (C) 2. The 30-year-old with exacerbation of multiple sclerosis (D) 3. The 5-month-old with pneumonia (B) 4. The 78-year-old with PEG tube post-gastrectomy (A)

Step-by-step solution

Identify each client's medical condition and treatment

A. 78-year-old who had a gastrectomy 3 weeks ago with a PEG (Percutaneous Endoscopic Gastrostomy) tube. B. 5-month-old discharged 1 week ago with pneumonia being treated with amoxicillin liquid suspension. C. 50-year-old with MRSA (Methicillin-resistant Staphylococcus aureus) being treated with Vancomycin via a PICC (Peripherally Inserted Central Catheter) line. D. 30-year-old with an exacerbation of multiple sclerosis being treated with cortisone via a centrally placed venous catheter.

Examine the urgency of each client's medical condition

A. The gastrectomy patient is in recovery and relies on a PEG tube for nutrition. This situation requires monitoring, but the surgery took place 3 weeks ago. B. The infant with pneumonia has been discharged, indicating improvement, and is receiving antibiotic treatment. C. A patient with MRSA has a severe bacterial infection, and intravenous treatment via a PICC line requires careful monitoring. D. The patient with multiple sclerosis is experiencing an exacerbation. Although serious, cortisone treatment should help manage the symptoms.

Rank the clients by urgency

1. The 50-year-old with MRSA (C) 2. The 30-year-old with exacerbation of multiple sclerosis (D) 3. The 5-month-old with pneumonia (B) 4. The 78-year-old with PEG tube post-gastrectomy (A)

Determine which client to visit first

Based on the medical urgency of each client, the home health nurse should visit the 50-year-old with MRSA being treated with Vancomycin via a PICC line (C) first. This client has the most pressing and potentially dangerous medical condition, requiring immediate attention and monitoring.

Key concepts

Patient Prioritization

In home health nursing, understanding which patient should be attended to first is crucial for effective care delivery. Patient prioritization involves evaluating the needs and conditions of each client to determine the sequence of visits. Various factors influence this decision, such as the severity of a patient’s condition, the potential risk to their health, and the level of support required. When prioritizing patients, nurses must carefully analyze medical histories, current treatments, and individual health goals. This ensures that those in the most urgent need of care receive it promptly. For example, a severe infection or an exacerbation of a chronic condition might take precedence over a stable post-surgery recovery. Often, prioritizing patient visits involves understanding the potential consequences of delaying care, which requires strong critical-thinking skills. It also necessitates clear communication with all members of the healthcare team to ensure that the chosen prioritization aligns with overall treatment plans.

Medical Urgency

Medical urgency is a critical concept in nursing that involves assessing the immediate health risks associated with various medical conditions. Identifying the level of urgency helps nurses to take swift action, potentially preventing a patient's condition from worsening. Factors that determine medical urgency include:

• The severity of the symptoms
• Potential complications if treatment is delayed
• The rate at which the condition can deteriorate

For instance, conditions like MRSA (Methicillin-resistant Staphylococcus aureus), a serious and potentially life-threatening infection, demand immediate attention due to their rapid progression and the risk of severe complications. Understanding medical urgency enables nurses to make informed decisions about patient care priorities. It ensures that resources are appropriately allocated, saving lives and improving patient outcomes.

Nursing Care Planning

Nursing care planning is a structured method used by nurses to provide individualized care to patients. This planning reflects the patient's specific medical needs, preferences, and overall health goals. A well-devised care plan serves as a roadmap for delivering effective and efficient nursing interventions. The elements of a nursing care plan include:

• Assessment: Gathering comprehensive information about the patient’s condition
• Diagnosis: Analyzing the data to determine the patient’s health status and needs
• Planning: Establishing priorities, setting goals, and choosing appropriate interventions
• Implementation: Carrying out the interventions based on the plan
• Evaluation: Regularly assessing the effectiveness of the interventions and adjusting the plan as necessary

An evidence-based approach is key in nursing care planning, ensuring that decisions are supported by the latest research and clinical guidelines. This approach helps in optimizing patient care and enhances the healing process.

Infection Control

Infection control is an essential component of nursing care, especially in home health settings. With patients often being treated for infections or recovering from surgeries, nurses play a vital role in implementing infection control measures to prevent the spread of pathogens. Key infection control practices include:

• Hand hygiene: Regular handwashing with soap and water or using alcohol-based hand sanitizers
• Use of personal protective equipment (PPE): Gloves, masks, and gowns to protect both the nurse and the patient
• Cleaning and disinfection: Regular cleaning of equipment and surfaces to eliminate potential germs
• Waste management: Proper disposal of medical waste to prevent contamination

In cases where infections like MRSA are present, strict adherence to infection control protocols is crucial. This helps minimize the risk of transmission and ensures a safer environment for both healthcare providers and patients. By effectively implementing these practices, nurses can significantly reduce the incidence of healthcare-associated infections.