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Difficulty: HardSupport Systems

A home health nurse is evaluating the support system of a client with newly diagnosed end-stage heart failure who was recently discharged to live with their adult child. The client requires assistance with activities of daily living (ADLs) and complex medication management. Which of the following nursing actions are appropriate to promote a safe and effective support system? Select all that apply.

  1. Assess the adult child's employment schedule, available financial resources, and personal coping strategies.Answer
  2. Facilitate a referral for community-based respite care services to provide the adult child with intermittent relief.Answer
  3. C
    Suggest that the adult child assign the client's daily medication preparation to the 12-year-old grandchild to foster family involvement.
  4. D
    Delegate the assessment of the adult child's competency in administering the client's medications to the home health aide.
  5. Explore the family's cultural beliefs regarding chronic illness, caregiving expectations, and advanced directives.Answer
  6. F
    Recommend that the adult child avoid discussing the progressive nature of the illness with the client to prevent emotional distress.

Answer

The correct nursing actions are assessing the caregiver's capacity, facilitating community respite care referrals, and exploring the family's cultural beliefs.
To establish an effective support system, the nurse must comprehensively assess the primary caregiver's psychosocial and financial capacity to manage the client's needs. Proactively facilitating community-based respite care mitigates caregiver burnout and role strain. Furthermore, exploring the family's cultural and spiritual beliefs ensures that the care plan aligns with their values and expectations, which heavily influence caregiving dynamics and enhance the sustainability of the support system.

Step-by-Step Solution

1
Analyze the goal of the nursing interventions in the context of the scenario.
The primary objective is to evaluate and establish a safe, effective, and sustainable psychosocial support system for a client with a progressive chronic illness who is transitioning to home care.
Identifying the core objective allows the nurse to distinguish between actions that strengthen the support system and those that are unsafe, nontherapeutic, or inappropriate.
2
Evaluate each nursing action against the principles of safe caregiving, appropriate delegation, and therapeutic communication.
Assessing caregiver resources, offering respite care, and discussing cultural beliefs actively strengthen the support network. In contrast, delegating assessment to unlicensed personnel, relying on a young child for medication preparation, and encouraging secrecy are unsafe and weaken the support system.
A robust support system requires competent caregivers, adequate community resources, and open, autonomous communication respecting the client's rights.

Key Concept

Evaluating and Strengthening Psychosocial Support Systems
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Topics

Support Systems

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