NCLEX-RNManagement of CareMedium
An 82-year-old client who lives alone is being discharged after being newly started on insulin therapy. The client has poor vision and limited hand dexterity. Which action by the nurse best promotes continuity of care?
- AAsk the client's pharmacy to call with reminders about insulin administration
- BInstruct the client to have a neighbor check in periodically after discharge
- CProvide written discharge instructions in large print for the client to review at home
- DRefer the client to a home health nurse and social services before discharge
Show answer & explanationAnswer & explanation
Correct answer: D. Refer the client to a home health nurse and social services before discharge
Given the client's physical limitations and lack of support, a referral to home health and social services ensures ongoing supervised care, medication administration assistance, and safety monitoring after discharge — the most comprehensive approach to continuity of care.
Why the other options are wrong
- A. Pharmacy reminder calls do not provide hands-on assistance with insulin administration.
- B. An informal neighbor check-in is not a reliable or sustainable safety net.
- C. Large print materials do not address the client's dexterity limitations for administering insulin.
Continuity of Care/Discharge Planning
Discharge planning must address a client's physical, cognitive, and social limitations by coordinating appropriate referrals (e.g., home health, social services) to ensure safe transition from hospital to home.
- Identify barriers to self-care before discharge
- Formal referrals provide more reliable support than informal arrangements
- Continuity of care spans across settings and providers
Memory trick: Bridge the gap — refer, don't just instruct.