A charge nurse on a medical-surgical unit is assisting with the emergency response plan following an external disaster in the community.
In anticipation of multiple client admissions, which of the following current clients should the nurse recommend for early discharge?
A.
A client who is receiving heparin for deep-vein thrombosis.
B.
A client who is 1 day postoperative following a vertebroplasty.
C.
A client who has cancer and a sealed implant for radiation therapy.
D.
A client who has COPD and a respiratory rate of 44/min.
The correct answer and Explanation is :
The correct answer is B. A client who is 1 day postoperative following a vertebroplasty.
Explanation:
In an emergency response plan, particularly when anticipating multiple client admissions due to an external disaster, prioritizing patient discharge is crucial for optimizing bed availability and ensuring resources are allocated efficiently. The goal is to discharge patients who can be safely sent home and who are least likely to require intensive, ongoing care.
Here’s a detailed breakdown of why each option is considered:
A. A client who is receiving heparin for deep-vein thrombosis (DVT): This patient is on anticoagulant therapy and requires careful monitoring to avoid complications such as bleeding. While their condition might be stable, early discharge could pose a risk of inadequate follow-up and monitoring for bleeding complications or adjustments in medication.
B. A client who is 1 day postoperative following a vertebroplasty: A vertebroplasty is a procedure to stabilize a vertebral fracture, often performed in patients with conditions like osteoporosis. By 1 day postoperative, if the patient’s condition is stable, they are often in a recovery phase where they can be safely discharged with appropriate instructions for home care. This makes them a candidate for early discharge to free up a bed for incoming disaster patients. This decision should be based on the patient’s overall stability, pain management, and home care support.
C. A client who has cancer and a sealed implant for radiation therapy: This client requires specific safety protocols due to the nature of the sealed radiation source. Discharge planning for such patients involves careful consideration of radiation safety, home environment, and follow-up care, which can be more complex and require specialized instructions and precautions. Early discharge might not be advisable due to these complexities.
D. A client who has COPD and a respiratory rate of 44/min: This patient is experiencing a significant exacerbation of COPD, as indicated by a high respiratory rate. Such a condition indicates instability and a need for close monitoring and management. Discharging this patient early would risk worsening their condition and potentially lead to severe complications.
In summary, among the given options, the client who is 1 day postoperative following a vertebroplasty is the most suitable for early discharge, provided their condition is stable and they have appropriate follow-up arrangements.