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Difficulty: MediumSelf-Care

A community health nurse is conducting a home visit to evaluate the self-care practices and health literacy of an older adult client who has type 2 diabetes mellitus and a history of mild dysphagia. The client employs an unlicensed assistive personnel (UAP) for assistance with basic activities of daily living. Which observations or statements by the client indicate a correct understanding of safe self-care management? Select all that apply.

  1. The client independently uses a long-handled shatterproof mirror to inspect the soles of the feet.Answer
  2. The client ensures the home's water heater is set to a maximum of 110°F (43.3°C).Answer
  3. The client schedules structured rest periods between morning grooming and dressing activities.Answer
  4. D
    The client states, "I will lie completely flat in bed immediately after eating to help my body digest the food."
  5. E
    The client states, "I am asking my home health aide to evaluate my swallowing ability during each meal."
  6. F
    The client states, "My sudden episodes of severe confusion yesterday are just a normal part of getting older."

Answer

The correct observations are the independent use of a long-handled mirror for foot inspection, setting the home water heater to a maximum of 110°F (43.3°C), and scheduling structured rest periods.
The correct options demonstrate evidence-based self-care and safety strategies for an older adult managing multiple chronic conditions. Using a long-handled mirror allows the client to independently assess the plantar surfaces of their feet without straining, which is essential for preventing diabetic ulcers. Limiting the home water heater temperature to a maximum of 110°F (43.3°C) prevents accidental scalding, providing a safe environment for a client who may have diminished temperature sensation due to diabetic neuropathy. Finally, pacing activities with scheduled rest periods is a foundational energy conservation technique that promotes sustained independence.

Step-by-Step Solution

1
Analyze the client's environmental and physical safety actions.
Using a long-handled mirror for foot inspection and setting the water heater to 110°F (43.3°C) are safe, effective self-care strategies for a client with diabetes.
These actions promote independence while minimizing the risk of undetected foot ulcers and accidental thermal injuries.
2
Evaluate the client's energy conservation strategies.
Scheduling rest periods between grooming activities demonstrates safe pacing.
Structuring activities prevents excessive fatigue and allows the client to maintain independence in their daily routine.
3
Evaluate the client's understanding of positioning and aspiration risks.
The client's plan to lie flat immediately after eating is unsafe.
Supine positioning post-meal significantly increases the risk of aspiration, which is a critical safety hazard for a client with dysphagia.
4
Assess the client's understanding of healthcare roles and symptom recognition.
Asking a UAP to evaluate swallowing is incorrect delegation, and attributing sudden confusion to normal aging is a dangerous misconception.
Clinical assessments cannot be delegated to a UAP. Furthermore, sudden confusion is an acute pathological sign requiring immediate medical intervention, not a normal part of aging.

Key Concept

Safe self-care management involves adapting activities for physical limitations, maintaining environmental safety, and distinguishing acute pathology from normal aging.
Estimated Time:1m 30s
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Self-Care

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