Chapter 25: Family-Centered Home Care

Chapter 25: Family-Centered Home Care

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The parents of a child on a ventilator tell the nurse that their insurance company wants the child to be discharged. They explain that they do not want the child home “under any circumstances.” Which of the following should the nurse consider when working with this family?

a.	Desire to have the child home is essential to effective home care.
b.	Parents should not be expected to care for a technology-dependent child.
c.	Having a technology-dependent child at home is better for both the child and the family.
d.	Parents are not part of the decision-making process because of the costs of hospitalization.

 

 

ANS:  A

Home care requires the family to manage the child’s illness, including providing daily hands-on care, monitoring the child’s medical condition, and educating others to care for the child. The child’s home environment with the child’s family is perceived as the best place for the child to be cared for. If the family does not want to or is not able to assume these responsibilities, other arrangements need to be investigated. The family is an essential part of the decision process. Without family involvement and support, the technology-dependent child will not be well cared for at home.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 948             TOP:   Nursing Process: Planning

MSC:  Client Needs: Psychosocial Integrity

 

2. A child with a serious chronic illness will soon go home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. This request should be considered which of the following?

a.	Improper because of legal issues
b.	Supportive because families are usually eager to get involved
c.	Unacceptable because the family will have to assume the care soon enough
d.	Important because it can be beneficial to the transition from hospital to home

 

 

ANS:  D

This type of groundwork is essential for the family. Adequate family training and preparation will assist in the child’s transition home. The nursing staff in the hospital is responsible for the child’s care. The family will provide the care with assistance as needed. Although parents are eager to be involved, the purpose of this intervention is the development of family competency and confidence that they are capable. Arrangements for respite care are important for the family both during hospitalizations and while the child is at home.

 

DIF:    Cognitive Level: Comprehension     REF:   pp. 949, 950   TOP:   Nursing Process: Planning

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

3. For case management to be most effective, who of the following is the most appropriate case manager?

a.	Nurse
b.	Panel of experts
c.	Multidisciplinary team
d.	Insurance company

 

 

ANS:  A

Nursing case managers are ideally suited to provide the care coordination necessary. Care coordination is most effective if a single person works with the family to accomplish the many tasks and responsibilities that are necessary. The family retains the role as primary decision maker. Most likely the insurance company will have a case manager focusing on the financial aspects of care. This does not include coordination of care to assist the family.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 951

TOP:   Nursing Process: Implementation

MSC:  Client Needs: Safe and Effective Care Environment: Management of Care

 

4. An adolescent with long-term, complex health care needs will soon be discharged from the hospital. A nurse case manager has been assigned to the teen and family. The adolescent’s care involves physical therapy, occupational therapy, and speech therapy, in addition to medical and nursing care. Who should be the decision maker in the adolescent’s care?

a.	Adolescent
b.	Nurse case manager
c.	Adolescent and family
d.	Multidisciplinary health care team

 

 

ANS:  C

The extent to which children are involved in their own care and decision making depends on many factors, including the child’s developmental age, level of interest, physical ability, and parental support. If the adolescent is developmentally age appropriate, then decision making should be the responsibility of child and family. Family needs to be involved because they will be caring for the adolescent in the home. Health care providers have necessary input into the care of the child, but ultimate decision making rests with the adolescent and family.

 

DIF:    Cognitive Level: Application           REF:   p. 958             TOP:   Nursing Process: Planning

MSC:   Client Needs: Safe and Effective Care Environment: Management of Care