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Difficulty: MediumSelf-Care

During mealtime at a subacute care facility, a practical nurse observes a client with multiple sclerosis struggling to eat independently due to bilateral hand tremors. The client is attempting to consume a specific meal brought by their family to adhere to religious dietary laws. Which intervention best promotes the client's self-care capabilities?

  1. A
    Exchange the family's prepared meal for the facility's standard mechanical soft diet to decrease the client's physical exertion.
  2. B
    Ask the client, 'Why do you insist on feeding yourself when it is making you so tired?' to encourage them to accept total assistance.
  3. Supply the client with weighted silverware and a rimmed plate while serving the family-provided meal.Answer
  4. D
    Perform an initial comprehensive dysphagia evaluation to determine if the client requires a prescribed change in diet consistency.

Answer

The correct action is to provide adaptive feeding equipment, such as weighted silverware and a rimmed plate, while ensuring the client receives their family-provided, culturally appropriate meal.
The correct answer emphasizes supporting the client's independence by offering specific adaptive tools designed for tremors, while concurrently respecting their religious practices by utilizing the culturally appropriate meal provided by their family.

Step-by-Step Solution

1
Assess the barrier to the client's self-care independence.
The primary barrier is impaired fine motor control (bilateral hand tremors) caused by multiple sclerosis.
Identifying the specific physical limitation helps determine the appropriate adaptive intervention.
2
Identify interventions that address the motor deficit without compromising other client needs.
Weighted silverware dampens tremors, and a rimmed plate prevents food spillage.
These adaptive devices bridge the gap between the client's functional deficit and their desire to maintain independence with ADLs.
3
Evaluate the proposed intervention against psychosocial and cultural safety requirements.
Providing the adaptive equipment allows the client to successfully eat the specific meal brought by their family.
Self-care promotion must always align with holistic care principles, including the strict observance of the client's religious and cultural dietary practices.

Key Concept

Promoting Independence in Activities of Daily Living (ADLs) through Adaptive Equipment and Cultural Competency
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Topics

Self-Care

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