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Zorluk: Çok zorSelf-Care

A nurse in an outpatient clinic is designing a self-care maintenance program for a 77-year-old client who lives alone. The client has a history of advanced osteoarthritis affecting the hands and hips, diabetic peripheral neuropathy, and a recent onset of stress incontinence. Which action should the nurse include in the client's individualized plan?

  1. A
    Explain that the recent onset of incontinence is an expected physiological change associated with aging and prioritize teaching regarding the use of absorbent briefs.
  2. B
    Assign the clinic's unlicensed assistive personnel (UAP) to perform the initial evaluation of the client's home layout to determine the specific types of adaptive bathing equipment needed.
  3. Recommend replacing clothing buttons with hook-and-loop fasteners, coordinate the installation of an elevated toilet seat, and initiate instruction on pelvic floor muscle exercises.Cevap
  4. D
    Schedule the client for a dual-energy x-ray absorptiometry (DEXA) scan as a primary prevention strategy to monitor the progression of the osteoarthritic joint degeneration.

Cevap

The nurse should recommend hook-and-loop fasteners for clothing, arrange for an elevated toilet seat, and teach pelvic floor muscle exercises.
The correct answer promotes independent self-care by addressing the client's specific physical limitations. Hook-and-loop fasteners compensate for the loss of fine motor skills due to severe hand osteoarthritis, allowing for independent dressing. An elevated toilet seat reduces the degree of hip and knee flexion required, accommodating hip osteoarthritis for independent toileting. Teaching pelvic floor muscle exercises provides an active self-management strategy for stress incontinence, rather than promoting dependence.

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1
Analyze the client's physical limitations and new symptoms.
The client has poor fine motor skills (hand osteoarthritis), impaired lower body mobility (hip osteoarthritis), and a new physiological issue (stress incontinence).
Identifying functional deficits is the required first step in planning appropriate self-care interventions.
2
Evaluate the proposed interventions against the goal of promoting independent self-care.
Adaptive equipment directly compensates for mobility deficits (Velcro for hands, raised seat for hips), and pelvic floor exercises actively treat the incontinence.
Effective self-care plans maximize the client's existing abilities and provide tools to overcome specific barriers rather than accepting dependence.
3
Identify clinical errors in the alternative options to eliminate them.
The alternative options demonstrate inappropriate delegation to a UAP, a misunderstanding of normal aging versus pathology, and incorrect application of prevention levels.
A safe and effective nurse must accurately apply scope of practice, gerontological principles, and disease prevention concepts when managing care.

Anahtar Kavram

Promoting Self-Care Independence through Adaptive Devices and Active Management
Tahmini Süre:1m 30s
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Self-Care

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