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Difficulty: HardHealth Promotion and Disease Prevention

A community health nurse is establishing a health promotion and disease prevention plan for a 70-year-old client who has recently relocated to the area. The client reports a sedentary lifestyle, new-onset occasional urinary incontinence, and has a 30-pack-year smoking history, though they quit 5 years ago. Which nursing action demonstrates the correct application of a secondary prevention strategy for this client?

  1. A
    Administering the recommended respiratory syncytial virus (RSV) and pneumococcal vaccines.
  2. B
    Instructing the client on bladder training techniques to manage the urinary incontinence.
  3. Facilitating a referral for an annual low-dose computed tomography (LDCT) scan to screen for lung cancer.Answer
  4. D
    Reassuring the client that urinary incontinence is an expected physiological change of aging.

Answer

Facilitating a referral for an annual low-dose computed tomography (LDCT) scan to screen for lung cancer.
Secondary prevention focuses on the early detection and screening of asymptomatic individuals who are at high risk for a specific disease. According to current preventive health guidelines, adults aged 50 to 80 years with a 20-pack-year or more smoking history who currently smoke or have quit within the past 15 years require annual screening for lung cancer with a low-dose computed tomography (LDCT) scan. Because this client is 70 years old with a 30-pack-year history and quit 5 years ago, facilitating this screening perfectly aligns with the definition of secondary prevention.

Step-by-Step Solution

1
Analyze the client's clinical profile and history.
The client is an older adult with a significant smoking history (30-pack-years, quit 5 years ago) and a new pathological symptom (urinary incontinence).
Identifying risk factors and current symptoms is required to determine appropriate, individualized interventions.
2
Define the goal of the nursing action based on the question stem.
The stem specifically asks for a 'secondary prevention' strategy.
Understanding the levels of prevention (primary, secondary, tertiary) is essential for categorizing nursing interventions accurately.
3
Evaluate each option against the definition of secondary prevention.
LDCT screening for lung cancer is early detection (secondary). Vaccinations are primary. Bladder training is tertiary. Dismissing incontinence is an assessment error.
Secondary prevention focuses exclusively on screening asymptomatic, high-risk individuals for early detection and prompt treatment of disease.

Key Concept

Levels of Disease Prevention and Preventive Health Screening
Estimated Time:1m 30s
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Topics

Health Promotion and Disease Prevention

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