Examkin

Soru

Zorluk: KolayDisposition and Care Setting Transitions

Following a left middle cerebral artery ischemic stroke, a 71-year-old female patient is medically stabilized on the neurology ward. It is hospital day six, and her vitals are within normal limits. She exhibits residual right hemiparesis and moderate expressive aphasia. During evaluation, therapists note she needs substantial physical assistance to move from bed to chair. Despite these deficits, she follows commands well, shows strong motivation, and has demonstrated the stamina to participate in three hours of active, multimodal therapy (physical, occupational, and speech) each day. Her spouse is elderly and cannot physically lift her.

Which of the following is the most appropriate next step in care setting transition?

  1. Transfer to an inpatient rehabilitation facilityCevap
  2. B
    Transfer to a skilled nursing facility
  3. C
    Transfer to a long-term acute care hospital
  4. D
    Discharge home with scheduled home health visits
  5. E
    Discharge home with outpatient therapy clinic referrals

Cevap

Transfer to an inpatient rehabilitation facility
Patients recovering from an acute stroke who are medically stable, have significant functional deficits requiring multiple therapy modalities, and have the demonstrated stamina to participate in at least 3 hours of therapy per day are ideal candidates for an inpatient rehabilitation facility. This setting provides coordinated, intensive rehabilitation to maximize functional recovery before transitioning to a lower level of care or home.

Adım Adım Çözüm

1
Assess the patient's medical stability and current functional status.
The patient is medically stabilized but has significant physical and speech deficits requiring substantial transfer assistance.
Determining baseline function and acute medical needs is the first step in evaluating care transition eligibility.
2
Evaluate the patient's rehabilitation potential and stamina.
The patient can tolerate and actively participate in 3 hours of intensive, multimodal therapy daily.
Rehabilitation stamina directly determines eligibility for specific levels of post-acute institutional care.
3
Assess the home environment and caregiver support.
The spouse is unable to provide the necessary physical assistance for safe transfers at home.
Inadequate physical support at home rules out a safe discharge to the home setting.
4
Synthesize findings to select the appropriate facility.
The combination of medical stability, need for multimodal therapy, and ability to tolerate 3 hours of daily therapy indicates an inpatient rehabilitation facility.
This setting provides the necessary level of intensive therapy while safely accommodating her nursing and mobility needs.

Anahtar Kavram

Patients with functional deficits following an acute illness who are medically stable and can tolerate at least 3 hours of intensive, multidisciplinary therapy daily should be transferred to an inpatient rehabilitation facility.
Bu soruyu puanla

Konular

Disposition and Care Setting Transitions

Bu konudan daha fazla soru