Question

You are a home health nurse visiting an 85-year-old client, Mrs. Smith, in her home. Mrs. Smith lives alone and has a small dog for companionship. Her daughter comes to visit every Sunday. Mrs. Smith takes a total of seven different medications and keeps them in unlabeled containers. She is also prescribed home oxygen therapy. Upon observing the client’s environment, you notice that the living room is dimly lit. Mrs. Smith tells you, “I don’t like a lot of lights, but I use this lamp here next to my chair.” You notice the lamp is plugged into an extension cord attached to an outlet across the room. You also see an ash tray on the client’s table. You inquire if the client smokes. Mrs. Smith replies, “Oh, no. I don’t smoke, but my daughter does.”

• Discuss the safety hazards observed in the client’s home.
• Describe any nursing actions you would take to promote safety.
• Explain the teaching points you would reinforce to the client and family.

Answer 1

a) The safety hazards observed in Mrs. Smith’s home are:

1. Mrs. Smith takes a total of seven different medications and keeps them in unlabeled containers. This is certainly a safety hazard for an 85-year-old who is living alone. There are chances of taking the medicines interchangeably.

2. The living room is dimly lit. There are chances of the client unable to see properly and might trip and fall resulting in an emergency. The living room lamp is plugged into an extension cord attached to an outlet across the room, which could aggravate the situation and cause a more severe fall injury along with chances of electrocution.

3. Exposure to passive smoking from her daughter who visits her every Sunday. Though smoking in any form is injurious to health, secondhand smoking is more dangerous as it has the smoke from burning tobacco as well as the smoke exhaled by the smoker. The burning tobacco smoke contains more harmful chemicals than the smoke inhaled by the smoker. Thus passive or secondhand smokers are at a higher risk of smoking-related diseases.

b) Nursing actions to promote the client's safety:

1. Instruct the client to keep the medications in labeled containers to avoid confusion and using them interchangeably, show her and help her to do this.

2. The home should be well-lit and free of any power cords across the floor to avoid any trip and fall. Help the client to make her home more elderly-friendly without any chances of trip and fall.

3. The client and her daughter should be instructed on the harmful effects of passive smoking on an elderly person.  

c) Teaching points reinforced to the client and family:

1. Instructions to keep the medications in labeled containers.

2. Instructions to make the home well-lit without any cords across the floor.

3. Instructions should be given to the daughter to stop smoking inside the house.