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Difficulty: MediumHealth Promotion and Disease Prevention

A nurse in an ambulatory care clinic is evaluating a 55-year-old male client who has not visited a healthcare provider in over a decade. The client is currently asymptomatic but reports a strong family history of type 2 diabetes mellitus and colorectal cancer. Which of the following nursing actions are appropriate regarding this client's health promotion and disease prevention plan? Select all that apply.

  1. Recommend a screening colonoscopy or fecal immunochemical test (FIT) for colorectal cancer detection.Answer
  2. Prepare to administer the recombinant zoster vaccine (RZV) as a primary prevention measure against shingles.Answer
  3. Obtain an order for a fasting blood glucose or hemoglobin A1c level to screen for diabetes mellitus.Answer
  4. D
    Educate the client that the annual influenza vaccination is an important secondary prevention strategy.
  5. E
    Inform the client that sudden periods of confusion and memory loss are expected physiological changes of aging.
  6. F
    Delegate the collection of the comprehensive health history and risk assessment to the unlicensed assistive personnel (UAP).

Answer

The correct actions include recommending colorectal cancer screening, administering the recombinant zoster vaccine, and screening for diabetes mellitus.
Appropriate health promotion for a 55-year-old adult includes primary prevention strategies like the recombinant zoster vaccine (recommended for adults 50 and older) and secondary prevention strategies like screenings for colorectal cancer and type 2 diabetes, which are particularly important given the client's age and family history.

Step-by-Step Solution

1
Analyze the client's demographic data and health history.
The client is a 55-year-old male with a family history of colorectal cancer and type 2 diabetes who lacks recent healthcare maintenance.
Identifying age and genetic risk factors determines which specific health screenings and immunizations are indicated.
2
Determine appropriate primary prevention interventions.
Identify the need for age-appropriate immunizations, specifically the recombinant zoster vaccine for adults aged 50 and older.
Primary prevention aims to prevent disease before it occurs.
3
Determine appropriate secondary prevention interventions.
Identify the need for colorectal cancer screening (indicated for adults > 45) and diabetes screening (indicated due to family history and age).
Secondary prevention focuses on early detection and treatment of asymptomatic diseases.
4
Evaluate remaining options for clinical errors.
Reject options that misclassify vaccinations as secondary prevention, falsely attribute sudden confusion to normal aging, or improperly delegate nursing assessments.
Ensuring safe nursing practice requires accurate knowledge of prevention levels, aging physiology, and the RN scope of practice.

Key Concept

Age-appropriate health screening and primary prevention strategies
Estimated Time:1m 30s
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Topics

Health Promotion and Disease Prevention

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