WEEK 4: TOPIC 9 RESPIRATORY & CIRCULATION

The nurse is performing smoking cessation with an older adult who has smoked two packs per day of cigarettes since the client's late teens. The client responds, "At this point in my life, I think it's probably too late to quit". How should the nurse BEST respond to the client's statement?

"ACTUALLY, YOU'LL START TO ENJOY SOME HEALTH BENEFITS ALMOST AS SOON AS YOU QUIT."

The nurse identifies the diagnosis of Excess Fluid Volume for a client with heart failure. Which intervention should the nurse add to this client's plan of care? Select all that apply.

- Weigh daily - Monitor intake and output - Elevate edematous extremities - Apply antiembolism stockings

The nurse suspects that an older client has undiagnosed cardiovascular problem. Which finding caused the nurse to come to this clinical decision?

ABSENCE OF LEG HAIR

The nurse prepared to perform postural drainage on an older client with chronic obstructive pulmonary disease. What action should the nurse take first?

ADMINISTER AEROSOL MEDS

A community nurse develops wellness outcomes for those at higher risk for poor management of cardiovascular disease. Which population should the nurse target?

AFRICAN AMERICAN WOMEN

The nurse suspects that an older client is experiencing an alteration in tissue perfusion. What assessment finding caused the nurse to make this clinical decision?

ANKLE EDEMA

An older adult client smoked for 30 years and has a history of chronic obstructive pulmonary disease. The client's spouse assists with cooking, cleaning, and transportation. The spouse has become ill, and they now receive assistance from a home health nurse. Which intervention should be the PRIORITY?

DETERMINING A PLAN FOR PROVIDING MEALS

A nurse admits an older adult client to the hospital with aspiration pneumonia. Which risk factor should the nurse predict that the client has in the client's history?

DYSPHAGIA

During a home visit the nurse suspects that an older client is experiencing congestive heart failure. What did the nurse assess in this client?

DYSPNEA ON EXERTION

The nurse prepares to instruct a client on abdominal breathing. What should the nurse have available before beginning these instructions?

SMALL PILLOW

Which is the MOST important remediable risk factor for cardiovascular disease in older adults?

SMOKING

An older client with cardiovascular disease experiences vagal episodes. What should the nurse suggest to reduce these episodes from occurring in the future?

STOOL SOFTENER (straining from constipation, enemas, and removal offecal impactions canc cause vagal stimulation)

An older client is experiencing a non-productive cough. What should the nurse encourage to help save this client's energy?

SUCK ON A PIECE OF HARD CANDY! (increases secretions, help cough production)

A nurse assesses older adults at a pulmonary clinic. Which question might best assist in identifying those at risk for pulmonary disorders?

"WHAT TYPE OF JOB DID YOU HAVE?"

Which assessment findings confirm that an older client is adhering to the Ornish Reversal Diet? Select all that apply.

- CLIENT EATS HIGH-FIBER FOODS - CLIENT DRINKS NONFAT MILK - CLIENT HAS NO CALORIE RESTRICTION - CLIENT EXCLUDES OILS FROM DIET

The nurse is assessing an older client who has a nursing diagnosis of ineffective tissue perfusion. Which assessment findings should the nurse anticipate?

- EDEMA - PALLOR - COOL SKIN - RESTLESSNESS

An older client with emphysema is prescribed oxygen via nasal cannula. What should the nurse keep in mind when monitoring this client's oxygen therapy?

A LOW OXYGEN LEVEL STIMULATES BREATHING

An older client reports attempting smoking cessation several times without success. What should the nurse recommend to this client?

ACUPUNCTURE

An older adult client states that many of her peers have hypertension. When explaining this phenomenon, what the nurse describe?

AGE-ASSOCIATED VASOCONSTRICTION

Which individual is likely at the highest risk for orthostatic hypotension?

AN 80yo CLIENT WHO STRAINS TO VOID WHEN USING THE BEDSIDE COMMODE

A nurse identifies clients who are at risk for modifiable risk factors for cardiovascular disease. Which client should the nurse PRIORITIZE as having modifiable cardiovascular functional consequences?

AN OLDER ADULT CLIENT WHO IS OBESE WHO HAS TYPE 2 DIABETES

An older client has a respiratory rate of 28 breaths per minute and shallow. What medication should the nurse consider is contributing to this client's respiratory rate?

ANALGESIC (pain reliever)

An older client reports weakness, fatigue, dizziness,palpitations, and fainting. Which health problem should the nurse suspect this client is experiencing?

ARRHYTHMIA

A client taking warfarin received an influenza vaccination. For what should the nurse monitor this client over the next 1 to 4 weeks?

BLEEDING

A client taking warfarin received an influenza vaccination. For what should the nurse monitor this client over the next 1-4 weeks?

BLEEDING

An older client is diagnosed with asthma. What should the nurse include when assessing this client?

BLOOD PRESSURE

An older client is experiencing purulent foul-smelling sputum. For which health problem should the nurse plan care for this client?

LUNG ABSCESS (TB = rust colored, red/frothy = pulmonary edema, grayish white = COPD)

An older client's apical pulse is 120 beats per minute after completing physical therapy exercises. What action should the nurse take?

REASSESS IN 2 HOURS

The nurse suspects that an older client's blood pressure will be within normal limits. What information from the medical record did the nurse use to come to this conclusion?

TAKES GARLIC PILLS EVERY DAY

The health care provider prescribes a C-reactive protein level to be measured on an older client. What should the nurse instruct the client to prepare for this laboratory test?

THERE IS NOTHING THAT NEEDS TO BE DONE TO PREPARE FOR THE TEST

A nurse assesses an older adult for dietary habits. Which statement by the client should the nurse identify as a positive dietary habit for cardiovascular functioning?

"I AVOID MEAT & EAT NUTS INSTEAD."

An older adult client with a long-standing history of chronic obstructive pulmonary disease was recently placed on warfarin after experiencing atrial fibrillation. Upon discharge from the hospital, which statement by the client indicates a need for further teaching?

"I WILL CONTINUE TO USE SMOKELESS TOBACCO SINCE IT'S A LOT BETTER THAN SMOKING"

Which statement by an older adult indicates the need for further teaching related to cholesterol reduction?

"I WILL DECREASE MY INTAKE OF FOOD HIGH IN POLYSATURATED FATTY ACID" (you wanna actually increase this, decrease saturated fats)

During a respiratory health promotion interview, an older client asks if it is important to have a ental examination after age 65. Which of the following is the most accurate response?

"INFECTIONS OF THE ORAL CAVITY CAN LEAD TO RESPIRATORY INFECTIONS."

An older client resists getting out of bed to walk after experiencing a myocardial infarction. What should the nurse explain to this client about activity?

"IT PREVENTS ANY PROBLEMS CAUSED BY LACK OF ACTIVITY."

The nurse instructs an older client on dietary changes to reduce the risk of cardiovascular disease. Which client statement indicates that teaching has been effective?

"OLIVE OIL IS GOOD FOR ME TO USE."

A nurse interviews an older adult with pulmonary disease. The client states, "I worked hard all my life

"TELL ME MORE ABOUT YOUR WORK IN THE SHIPYARD."

An older client experiences a chronic tickle in the back of the throat. What explanation should the nurse provide to the client about this finding?

"THERE'S MUCUS IN YOUR NASOPHARYNX THAT IS THICK AND HARD TO EXPEL."

An older adult client recently experienced a syncopal (fainting) episode after standing up quickly while gardening. Which assessment is the nurse's PRIORITY?

"WHAT MEDICATIONS DO YOU TAKE?"

The nurse is caring for a 75-year-old client who has been diagnosed with respiratory risks associated with aging. Which risks should the nurse discuss with the client? Select all that apply.

- Dislodged loose teeth can cause a lung abscess. - Mucus can contribute to cause mucus plugs and infection. - Pain may be mistaken for an ailment other than a respiratory problem and delay treatment. - Reduced fluid intake can cause drier mucous membranes.

Which statements demonstrate that the client has received effective education concerning the promotion of healthy cardiovascular function? Select all that apply.

- I RARELY EAT FRIED FOODS - WALKING IS A PART OF MY DAILY ROUTINE - IVE LOST 10lb and 5 MORE tO GO - I HAVEN't SMOKED CIGS IN 6 MONTHS

During a health promotion visit, the nurse should include which of the following guidelines when teaching an older client about dietary guidelines for reducing the risk of cardiovascular disease?

- REDUCE INTAKE OF FRIED FOODS - INCREASE INTAKE OF COMPLEX CARBS & FIBER - USE MONOUNSATURATED OILS WHENEVER POSSIBLE - REDUCE INTAKE OF SUGAR

The nurse plans care for a client with emphysema. Which interventions should the nurse identify for this client's plan of care? Select all that apply.

- STRESS REDUCTION - BRONCHODILATORS - POSTURAL DRAINAGE - BREATHING EXERCISES

The nurse suspects that an older client is not receiving the full benefit of prescribed oxygen therapy being delivered via nasal cannula. Which observation caused the nurse to question the effectiveness of this therapy?

CLIENT IS A MOUTH BREATHER

An older client experiences an exacerbation of COPD. What should the nurse expect when assessing this client?

COUGH

An older client is diagnosed with anxiety. Which nursing diagnosis most accurately links this problem with the client's risk for a cardiovascular disease?

DISTURBED SLEEP PATTERN

An older client with asthma asks what non-pharmacological actions to use to loosen airway passages. What should the nurse recommend to this client?

EAT A MEAL WITH GARLIC OR PEPPERS

The nurse who provide care in a long-term care setting are aware of the high prevalence and risks of cardiovascular disease among the older adults who live at the facility. Which measure is MOST likely to prevent heart disease among older adults?

ESTABLISHING AN EXERCISE

An older client asks why fish oil should be taken every day. What should the nurse include when responding to this client?

FISH OILS LOWER BLOOD PRESSURE

The nurse plans interventions to help prevent the development of a pulmonary embolism in an older client. What health problem is this client most likely experiencing at this time?

FRACTURED HIP

During an assessment the nurse feels vibrations when palpating an older's client chest. How should the nurse document this finding?

FREMITUS

While ambulating, a client with chronic obstructive pulmonary disease (COPD) becomes confused. What should the nurse do first?

HAVE THE CLIENT SIT DOWN

An older client is diagnosed with a reduced elastic recoil of the lungs during expiration. Which nursing diagnosis best describes that client's threat to adequate respiration?

IMPAIRED GAS EXCHANGE

An older client is diagnosed with a increased residual capacity of the lungs. Which nursing diagnosis describes the client's risk for adequate respiration?

INEFFECTIVE BREATHING PATTERN

During a health promotion visit, a 75yo client tells the nurse that she has been diagnosed with peripheral vascular disease. Which nursing diagnosis best describes the client condition?

INEFFECTIVE PERIPHERAL TISSUE PERFUSION

A 71-year-old client with a history of cardiovascular disease presents with hypotension, tachycardia, loss of hair on the extremities, and cyanosis. Which would be most important nursing diagnosis?

INEFFECTIVE TISSUE PERFUSION

A 71yo client with a history of cardiovascular disease presents with hypotension, tachycardia, loss of hair on the extremities, and cyanosis. Which would be the most important nursing diagnosis?

INEFFECTIVE TISSUE PERFUSION

A registered nurse completes an assessment of an older adult. Which physical assessment finding is within normal limits?

KYPHOSIS AND INCREASED ANTEROPOSTERIOR DIAMETER OF CHEST!!!

The nurse measures the daily weight of an older client with severe leg and abdominal edema. What additional objective measurement should the nurse use to evaluate the effectiveness of prescribed treatment?

LIMB CIRCUMFERENCE

The nurse educator is teaching a class to nursing staff about the effects of aging on respiration. Which of the following is most important to include in the lesson plan?

LOSS OF SKELETAL MUSCLE CAUSES KYPHOSIS & A REDUCTION IN VITAL CAPACITY

An older adult admitted to the emergency department exhibits dyspnea and a sudden change in level of consciousness. The nurse should assess first for which disorder?

MYOCARDIAL INFARCTION

An older client questions if a lung infection is present even without a change in body temperature. What should the nurse explain to this client?

NORMAL BODY TEMP LEVELS CHANGE WITH AGING

A nurse plans care for a frail older adult in long-term care. Which intervention should be included in the plan of care to reduce the risk of respiratory infections?

ORAL CARE

An older client reports fatigue and shortness of breath walking short distances since retiring from a job as a mail carrier. What should the nurse consider is occurring with this client?

PHYSICAL DECONDITIONING

An older client cannot remember if ever receiving a vaccine to prevent pneumonia. What should the nurse do?

PLAN TO GIVE THE INJECTION

An older adult client is brought to the emergency department from home with a sudden change in mental status accompanied by significant weakness. For which condition should the health care providers assess?

PNEUMONIA

The nurse is caring for an older client with an acute exacerbation of chronic bronchitis. What should the nurse identify as the goal for this client's care?

PREVENT AIRWAY OBSTRUCTION

An older client with heart failure is upset because the nursing staff turns and repositions the client every 2 hours. Why is this intervention a part of the client's plan of care?

REDUCES SKIN BREAKDOWN

Older adults experience a number of changes in the structure or function of their cardiovascular system. Which change is considered to be a normal, age-related change?

REGULATION OF BLOOD PRESSURE & HEART RATE BECOMES LESS EFFICIENT.

The nurse observes a pulsating mass near the umbilicus of an older client. What should the nurse do first?

REPORT THAT SHIT (FINDING)

The nurse is teaching a class to older adults about the effects of aging on respiration. Which of the following is important to include for this client population?

RESPIRATORY DISEASE IS A LEADING CAUSE OF DISABILITY IN PERSONS OVER 70 YEARS OF AGE

An older client diagnosed with pneumonia. What assessment finding indicates that the client is experiencing cerebral hypoxia?

RESTLESSNESS

An older client is diagnosed with pneumonia. What assessment finding indicates that the client is experiencing cerebral hypoxia?

RESTLESSNESS

Which nursing diagnosis is most important to include in the plan of care for a 79yo client diagnosed with decreased coronary blood flow?

RISK FOR DECREASED CARDIAC TISSUE PERFUSION

During an assessment of the head and neck the nurse suspects that an older client has emphysema. What finding caused the nurse to make this clinical determination?

RUDDY!

During a health promotion visit, the nurse should include which of the following guidelines when teaching an older client about dietary guidelines for reducing the risk of cardiovascular disease? Select all that apply.

Reduce intake of fried foods Increase intake of complex carbohydrates and fiber Use monounsaturated oils whenever possible Reduce intake of sugar

An older client with emphysema experiences activity intolerance. Which intervention should the nurse add to this client's plan of care?

SCHEDULE REST PERIODS BETWEEN ACTIVITIES

What client behavior is associated with the decrease of elastic recoil resulting from the aging process?

SIGNIFICANT USE OF ACCESSORY MUSCLES

An 85yo client broke 2 teeth after hitting them on the side-rail of her bed. The nurse has confirmed that she is not bleeding. Which of the following would be most crucial for the nurse to assess next?

SIGNS & SYMPTOMS OF RESPIRATORY COMPROMISE

The nurse conducts a physical assessment of an older client with a cardiovascular health problem. Which finding should the nurse expect t o assess in this client?

THICK DRY NAILS

An older client with congestive heart failure has lower extremity and sacral edema. Which intervention should the nurse add to this client's plan of care to protect tissue integrity?

TURN & REPOSITION EVERY 2 HOURS