Question

A newly hired home health care nurse is planning the initial visit to an adult client who has had multiple sclerosis (MS) for the past 20 years and is currently bed-bound and is lifted by a hoist. And unlicensed caregiver provides care 8 hours/ daily, 5 days/week. During the initial visit to this client, which intervention is most important to the nurse to implement?

Answer 1

Final answer:

The most important intervention during the initial visit by a home health care nurse to an MS client is a comprehensive health assessment. This includes supervising the care by the unlicensed caregiver, checking vital signs, equipment conditions, and addressing any barrier related to past trauma.

Step-by-step explanation:

During the initial visit to an adult client with multiple sclerosis (MS) who is bed-bound and lifted by a hoist, the most important intervention for a home health care nurse is to perform a comprehensive assessment of the client's current health status.

This involves directly supervising the care being provided by the unlicensed caregiver, ensuring that all procedures are performed correctly and safely. The nurse should focus on evaluating the client's skin integrity, potential for pressure ulcers, range of motion, and overall comfort level. Additionally, reviewing the client's medical history and any recent changes in their condition is crucial. Monitoring vital signs is also an important part of this assessment, as well as preparing and ensuring that all equipment used, like the hoist, is functioning properly and is sterile if necessary.

Case management strategies during this visit would also be a critical consideration, with an emphasis on setting realistic goals for mobility, within the individual's limitations, and addressing any barriers they may encounter. The nurse should gauge if any past traumas are impacting the client's care and adjust the approach accordingly to provide respectful and comprehensive support.

Answer 2

During the initial visit, the nurse should focus on a comprehensive assessment, supervise the unlicensed caregiver, and ensure proper case management strategies are in place. This involves reviewing patient history, assessing health status, and verifying the use of safe and sterile procedures.

Step-by-step explanation:

The most important intervention for a nurse to implement during the initial visit to an adult client with multiple sclerosis (MS) who is bed-bound would be a comprehensive assessment of the client's current health status. This includes reviewing the patient history, evaluating the current condition, and assessing the patient's needs. Since multiple sclerosis can lead to a wide variety of symptoms and complications, it is crucial for the nurse to establish a baseline of health and to understand the specific challenges and needs of the client. Direct supervision of a registered nurse could involve observing and evaluating the care provided by the unlicensed caregiver and ensuring that it meets the care plan created for the patient.

The initial visit may also focus on providing education to the unlicensed caregiver, especially with regard to safely using the hoist for lifting, to prevent potential injuries to the patient. Moreover, the nurse should evaluate and ensure that proper case management strategies are being applied, focusing on patient-centered goals such as preserving any mobility the patient has left and addressing any potential barriers to successful care, which in other instances have ranged from untreated trauma to family dysfunction. However, specific to this scenario, ensuring accurate and sterile procedures, especially if any dialysis treatments are involved, is also critical.

During the subsequent care period, it is vital to regularly monitor the patient's vital signs and to prepare for any eventualities that may arise from the progressive nature of MS. This can include having emergency protocols in place and regularly communicating with the healthcare team about any changes in the patient's condition.