Med-Surg · chapter 36 · Home Health Nursing and Rehabilitation
Additional Care Settings in the Community
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 3 practice questions with the reasoning.
Key points
Community clinic nursing
For example, nurses may work in community clinics to provide preventive care, health screenings, immunizations, and treatments for common illnesses, as well as health education to empower individuals and communities in making informed decisions about their well-being.
Rural primary care
Rural and remote regions often rely heavily on nurses as primary health-care providers due to limited access to medical facilities, providing a full array of health-care services, such as assessment, treatment, medication administration, and emergency responses.
Hospice nursing focus
The hospice and palliative care settings offer compassionate nursing services for individuals living with life-limiting illness. Nurses provide pain management, emotional support, and education about end-of-life care, while assuring patient comfort and dignity.
Hospice family support
The hospice nurse focuses on the patient’s needs and supports family members and loved ones during the death and dying transition.
Outpatient nursing assessments
Nurses working in outpatient settings conduct initial assessments and prioritize care according to urgency and necessity, gathering medical histories, performing vital sign measurements, and analyzing symptoms to guide appropriate interventions or referrals for each individual patient.
Ambulatory service scope
Ambulatory services cover an array of health-care needs, such as preventive services, diagnostic testing, imaging and laboratory analysis, vaccinations, physical therapy services, and minor surgery treatments, as well as follow-up visits for chronic disease management.
Workplace safety education
Working closely with occupational safety specialists, nurses develop and implement safety protocols. They educate employees on workplace health and safety practices, such as appropriate ergonomics, the use of PPE, health screenings, and strategies to avoid injuries and lead a healthy lifestyle.
Workplace injury response
Occupational health nurses specialize in injury management and first aid response plans in workplace settings. They often can offer immediate attention for workplace accidents or refer the individual to an acute care outpatient facility for treatment.
High-risk employee monitoring
Occupational health nurses routinely monitor employees working in high-risk environments, such as those working with potentially harmful chemicals or on construction sites. By conducting regular health assessments, occupational nurses can detect potential health concerns early and initiate effective solutions.
School health screening
School nurses conduct a variety of assessments to determine students’ needs and detect potential health concerns. They conduct vision and hearing screenings, monitor growth and development, and assess overall health status.
School chronic condition plans
School nurses also provide services for children experiencing chronic health conditions, such as diabetes, asthma, and allergies. They create individualized health plans, educate school staff about students’ needs, and ensure emergency medications such as EpiPens are easily available, should an emergency arise.
School emergency response
Nurses in school settings are trained to respond promptly to medical emergencies in school settings—for example, injuries, allergic reactions, and seizures—and offer immediate emergency assistance if necessary.
Homelessness health assessment
When working with a patient without housing, the nurse should conduct a health assessment to detect and address immediate health concerns and establish an evidence-based framework for ongoing care (de Buhr et al., 2022). The assessment should cover physical and mental conditions, substance use, and any chronic conditions.
Homelessness community resources
Nurses provide individuals experiencing homelessness with access to community resources such as shelters, food services, clothing donations, and employment assistance programs, as well as housing programs and social services.
Terms to know
- Outpatient health care or ambulatory services
- Outpatient health care or ambulatory services, also referred to as "ambulatory care,” refers to health-care services in which the patient receives care without needing hospital admission.
- occupational health
- The field of health care focused on improving and protecting employees in their place of work is called occupational health.
- school health programs
- School programs, more commonly referred to as school health programs, are comprehensive initiatives created to support students’ physical, emotional, and academic well-being within an educational setting (de Buhr et al., 2020).
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
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Every question here, with the answer
At 4:00 p.m., an occupational health nurse reviews documentation from regular health checks of employees who work with potentially harmful chemicals. Which documentation approach best supports identifying changes in employees' health over time?
- Maintain detailed employee medical histories and findings from regular health assessments.
- Focus on first-aid encounters and injury claims, adding health information when employees need treatment.
- Use workplace hazard assessments and safety-protocol updates as the main record for tracking employee health.
- Use vaccination and N95-check records as the primary record of employees' ongoing health status.
Answer: Maintain detailed employee medical histories and findings from regular health assessments.
Detailed medical histories and regular assessments support tracking health trends and identifying areas of concern. Hazard assessments describe workplace risks, while first-aid encounters and claims focus on injury-related care. Vaccination and N95-check records address specific safety measures rather than the broader health monitoring described.
At 2:00 p.m., a school nurse reviews a draft individualized care plan for a student with diabetes. The draft contains the student's medical history but does not explain how the student's needs will be supported at school. Which additions should the nurse make? Select all that apply.
- A standard diabetes information sheet designated as the student's complete care plan.
- Communication strategies for coordinating support for the student.
- Interventions addressing the student's specific medical needs.
- Student-specific accommodations needed during the school day.
- A note that communication arrangements will be discussed verbally when a problem occurs.
Answer: Communication strategies for coordinating support for the student., Interventions addressing the student's specific medical needs., Student-specific accommodations needed during the school day.
The section describes personalized care plans as outlining necessary accommodations, interventions, and communication strategies. A general information sheet does not provide an individualized plan, and deferring communication arrangements until a problem occurs leaves those strategies unspecified.
At 3:30 p.m., a school nurse finishes a student's vision and hearing screenings and reviews the student's vaccination information. While updating the student's health record, which approach best matches the recordkeeping described in the section?
- Keep assessment findings and medical history current, recording only immunizations administered at school.
- Keep immunization and screening records current, using the individualized care plan in place of the student's medical history.
- Keep immunization information and medical history current, adding assessment findings only when a chronic condition is identified.
- Keep immunization records, health assessment findings, and medical history accurate and current.
Answer: Keep immunization records, health assessment findings, and medical history accurate and current.
The section identifies immunization records, health assessments, and medical histories as components of accurate student health records. It does not limit assessment documentation to chronic conditions or immunization records to doses given at school. An individualized care plan outlines needed support; it does not replace the medical history.
Where every quote comes from
Section 36.3 Additional Care Settings in the Community of Medical-Surgical Nursing by Christy Bowen, Bridget Carey, Jessica Palozie, Maren Reinholdt, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.