Chapter 42: Family-Centred Home Care
MULTIPLE CHOICE
1. Home care is being considered for a young child who is ventilator dependent. Which
factor is most important in determining whether home care is appropriate?
a. Level of parents’ education
b. Presence of two parents in the home
c. Preparation and training of the family
d. Family’s ability to assume all health
care costs
ANS: C
The essential element is the training and preparation of the family, who must be able
to demonstrate all aspects of care for the child. In many areas it cannot be guaranteed
that nursing care will be available on a continual basis, and the family will have to care
for the child. The amount of formal education reached by the parents is not important,
it is the family’s ability to care adequately for the child in the home. At least two family
members should learn and demonstrate all aspects of the child’s care in the hospital,
but it does not have to be two parents. Few families can assume all health care costs.
Financial planning, including negotiating arrangements with the insurance company
and/or public programs, may be required.
DIF: Cognitive Level: Analysis REF: p. 1245 | Box 42-2
OBJ: Nursing Process: Implementation
2. What is one important thing home care nurses should do when communicating with
other professionals?
a. Ask others what they want to know.
b. Share everything known about the family.
c. Restrict communication to clinically
relevant information.
d. Recognize that confidentiality is not
possible.
ANS: C
Through both oral and written communication, the nurse will need to share clinically
relevant information with other involved health professionals, but this is all that should
, be shared. The nurse must assure families that they have a right to expect
confidentiality in regard to the data collected.
DIF: Cognitive Level: Application REF: p. 1249 |Nursing Alert
OBJ: Nursing Process: Planning
3. The home health nurse is looking after a child who requires complex care. The family
expresses frustration over obtaining accurate information concerning their child’s
illness and its management. What is the best action for the nurse to take?
a. Determine why the family is frustrated.
b. Refer the family to the child’s primary
care practitioner.
c. Clarify the family’s request and provide
the information they want.
d. Answer only questions that are
essential to the family knowledge
base.
ANS: C
The philosophical basis of family-centred practice is the recognition that the family is
the constant in the child’s life. It is essential and appropriate that the family have
complete and accurate information about their child’s illness and management. The
nurse may first have to clarify what information the family feels has not been
communicated. The family’s frustration arises from their perception that they are not
receiving information pertinent to their child’s care. Referring the family to the child’s
primary care practitioner does not help the family. The home health nurse should have
access to the necessary information.
DIF: Cognitive Level: Application REF: p. 1248 OBJ:
Nursing Process: Planning
4. A family wants to begin oral feeding of their 4-year-old son, who is ventilator
dependent and currently tube fed. They ask the home health nurse to feed him baby
food orally. The nurse recognizes a high risk of aspiration and an already compromised
respiratory status. What is the most appropriate nursing action?
a. Refuse to feed him orally because the risk
is too high.
b. Explain the risks involved and let the
family decide what should be done.
MULTIPLE CHOICE
1. Home care is being considered for a young child who is ventilator dependent. Which
factor is most important in determining whether home care is appropriate?
a. Level of parents’ education
b. Presence of two parents in the home
c. Preparation and training of the family
d. Family’s ability to assume all health
care costs
ANS: C
The essential element is the training and preparation of the family, who must be able
to demonstrate all aspects of care for the child. In many areas it cannot be guaranteed
that nursing care will be available on a continual basis, and the family will have to care
for the child. The amount of formal education reached by the parents is not important,
it is the family’s ability to care adequately for the child in the home. At least two family
members should learn and demonstrate all aspects of the child’s care in the hospital,
but it does not have to be two parents. Few families can assume all health care costs.
Financial planning, including negotiating arrangements with the insurance company
and/or public programs, may be required.
DIF: Cognitive Level: Analysis REF: p. 1245 | Box 42-2
OBJ: Nursing Process: Implementation
2. What is one important thing home care nurses should do when communicating with
other professionals?
a. Ask others what they want to know.
b. Share everything known about the family.
c. Restrict communication to clinically
relevant information.
d. Recognize that confidentiality is not
possible.
ANS: C
Through both oral and written communication, the nurse will need to share clinically
relevant information with other involved health professionals, but this is all that should
, be shared. The nurse must assure families that they have a right to expect
confidentiality in regard to the data collected.
DIF: Cognitive Level: Application REF: p. 1249 |Nursing Alert
OBJ: Nursing Process: Planning
3. The home health nurse is looking after a child who requires complex care. The family
expresses frustration over obtaining accurate information concerning their child’s
illness and its management. What is the best action for the nurse to take?
a. Determine why the family is frustrated.
b. Refer the family to the child’s primary
care practitioner.
c. Clarify the family’s request and provide
the information they want.
d. Answer only questions that are
essential to the family knowledge
base.
ANS: C
The philosophical basis of family-centred practice is the recognition that the family is
the constant in the child’s life. It is essential and appropriate that the family have
complete and accurate information about their child’s illness and management. The
nurse may first have to clarify what information the family feels has not been
communicated. The family’s frustration arises from their perception that they are not
receiving information pertinent to their child’s care. Referring the family to the child’s
primary care practitioner does not help the family. The home health nurse should have
access to the necessary information.
DIF: Cognitive Level: Application REF: p. 1248 OBJ:
Nursing Process: Planning
4. A family wants to begin oral feeding of their 4-year-old son, who is ventilator
dependent and currently tube fed. They ask the home health nurse to feed him baby
food orally. The nurse recognizes a high risk of aspiration and an already compromised
respiratory status. What is the most appropriate nursing action?
a. Refuse to feed him orally because the risk
is too high.
b. Explain the risks involved and let the
family decide what should be done.
