The outcome would be a change in clients' current or future health status as a result of the care they received. Other examples of outcome standards include clients ambulating without assistance or clients who have clear breath sounds Process standards focus on how well a facility conducts its activities. An example of a process standard is staff measuring vital signs every hour unless otherwise specified. Structure standards focus on the internal characteristics of a facility and its staff. The standards help determine if a facility has a structure that promotes high-quality care. An example of a structural standard is a nursing department providing opportunities for staff development to the nursing staff. The nurse is acting as a client advocate when the nurse contacts a social worker to assist the client with daily meal delivery services. Client advocacy involves contacting available resources on behalf of the client. The nurse should document the client's emotional concerns regarding discharge; however, this is not a demonstration of client advocacy. The nurse should identify the health care proxy can make health care decisions for the client if the client is no longer able to make decisions regarding treatment. The client should discuss his health care wishes with the health care proxy while he is able. The client's living will authorizes a designated health care proxy or the client's provider to use the living will for health care decisions when the client is no longer able to make decisions regarding treatment. The nurse should recommend a referral to a speech-language pathologist for a client who has had a stroke and exhibits dysarthria. Dysarthria is slurred speech resulting from paralysis of the tongue and muscles used for speaking. Early intervention by a speech-language pathologist can improve the client's recovery. Occupational therapist is correct. An occupational therapist helps the client who has physical limitations or disabilities gain an optimal level of independence to perform ADLs, such as bathing, dressing, grooming, and eating. Physical therapist is correct. A physical therapist can assess the client's strength and mobility, implement therapeutic strategies, and teach new skills to help compensate for physical limitations and help manage ADLs. Audiologist is incorrect. An audiologist specializes in assessing and determining hearing loss. There is no indication that the client needs a hearing assessment. Respiratory therapist is incorrect. A respiratory therapist can administer pulmonary function tests and assist in providing therapies, such as oxygen, to help manage respiratory health. There is no indication that the client needs respiratory support. Speech-language pathologist is correct. A speech-language pathologist can perform an in-depth assessment of the client's swallowing and communication abilities, and teach the client strategies for eating safely and performing other ADLs.
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