old people health obq

The LPN/LVN has just taken the health history of a frail elderly patient. Which finding best supports the admitting diagnosis of a stage III pressure area over the presacral region?

Fell 2 weeks ago and has been resting in bed because movement is painful; is having difficulty getting to the bathroom in time.

This condition may cause the older adult to develop hypertension.

arteiosclorosis

Constipation is problematic for the older adult patient. To maintain normal bowel pattern, the nurse institutes an appropriate dietary intervention of:

bread and bran

This musculoskeletal problem causes the individual to stoop forward.

kyphosis

ageism

age discrimiation

A 68-year-old male patient is having a yearly checkup. It is flu season and the physician recommends that the patient receive a flu shot. When the physician leaves the room, the patient tells the nurse that he doesn't want to get the shot because he has heard it will give him the flu. What is the flu? Why does the physician think that this vaccine is important for this patient? What are the current reccommendations, regarding the flu vaccine, for the elderly? How should the nurse respond? How effective is the flu vaccine?

A wide range of complications can be caused by influenza virus infection of the upper respiratory tract (nasal passages, throat) and lower respiratory tract (lungs). Sinus and ear infections are examples of moderate complications from flu, while pneumonia is a serious flu complication that can result from either influenza virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle (myositis, rhabdomyolysis) tissues, and multi-organ failure (for example, respiratory and kidney failure). Flu virus infection of the respiratory tract can trigger an extreme inflammatory response in the body and can lead to sepsis, the body's life-threatening response to infection. Flu also can make chronic medical problems worse. For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic heart disease may experience a worsening of this condition triggered by flu. Adults aged 65 years and older are recommended to get the flu shot and this pt is 68.The pt should educate the pt on the severity of the flu and the age recommendations for the shot. According to the CDC: A flu vaccine cannot cause flu illness. Flu vaccines that are administered with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been 'inactivated' and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The nasal spray flu vaccine does contain live viruses. However, the viruses are attenuated (weakened), and therefore cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other areas where warmer temperatures exist.

The long-term care LPN/LVN has a new resident with glaucoma. Interventions for care of a patient with glaucoma include:

Administering prescribed eye drops and gently applying pressure on the lacrimal duct for 1 minute to assist in rapid systemic absorption

What are the age-related changes associated with the integumentary system?

Aging skin is dry and thin, It loses tone and elasticity, thick yellow nails

Summarize the obvious changes associated with aging in the musculoskeletal system.

Decreased bone calcium, decreased fluid in the intervertrbral disks, decreased blood supply to the muscles, decreased joint mobility, decreased muscle mass. Those all lead to osteoporosis, decreased height, muscle strength, mobility and flexibility

As a caregiver, what are the stress-related problems that you may experience when caring for the older adult?

Depression, anxiety, and increased vulnerability to physical health problems. Grieving, insomnia, poor appetite, no longer care if groomed

You observe a skin tear and multiple bruises on a 72-year-old patient's arm during his weekly blood pressure check. When you inquire about the impaired skin, he begins crying and states, "I'm so clumsy; I fell into the door." You note this in the clinical record. The following month, the patient presents with a 4-cm bruise on his left cheek. He shares that his alcoholic son moved in with him 6 weeks ago, and he just tries to keep out of his way. After noting the subjective and objective data in the clinical record, your next action would be to:

Report the findings to the Area on Aging in accordance with your state guidelines for elder abuse.

Why is health care relevant to the older population becoming more complex?

Scientific advances in treating life-threatning conditions of the past, increased life expectancy, greater focus on ethical and legal issues related to life disease research and dying.

A nurse is caring for a male patient whose admitting diagnosis is "Rule out CVA." The nurse gives the patient a drink of water, and the patient struggles to swallow. As the nurse, what do you suspect the issue is? What should the nurse do first? What nursing interventions are appropriate for this patient?

Sit the patient upright; Reduce distraction during mealtime; Thicken liquids; Cue the patient to swallow; Do not offer fluid thru a straw - this increases the possibility of aspiration; The upright position, leaning slightly forward with the chin down, improves swallowing with the assistance of gravity.

Explain the age-related changes in the genitourinary system specific to men and woman.

The kidney and bladder function decreases. For men: Prostate enlargement, which can obstruct the flow of urine and a pendulous scrotum. Women: estrogen levels decline, intercourse can be painful from the vagina getting shorter, constricting opening, losing tone and drying.

Describe the nursing interventions for the older adult with peripheral vascular disease.

The patient with peripheral vascular disease or diabetes should receive education or reinforcement about skin and foot care. Intermittent claudication and other chronic peripheral vascular diseases reduce oxygenation to the feet, making them susceptible to injury and poor healing; therefore, meticulous foot care is essential. Daily walking benefits the patient with intermittent claudication.

When caring for the older adult, what specific concerns and interventions are recommended for the gastrointestinal system?

constipation, fecal incontinance, gastrointestinal bleeding and cancer, obesity, weight loss/gain, fluids and dehydration, oral hygene, gastric reflux, dysphagia

A 70-year-old patient has smoked 1 ½ packs of cigarettes daily for 37 years. He stopped smoking when his COPD worsened and required the use of oxygen. He is admitted to the hospital for work-up, including a CT scan of the chest, following chest pain and hemoptysis. An appropriate nursing diagnosis is:

deficient knowledge

A patient arrives at the clinic for the third time in 1 month. She reports insomnia, multiple health concerns, decreased appetite, and fatigue. She states, "I'm so sick. I can't even get out to my quilting group. I haven't been quilting since my kitten died." The nurse would:

depression

What are the major changes in the reproductive system related to aging?

diminished lvls of estrogen and progesterone in women and diminished lvls of androgen and testosterone in men

This element of the integumentary system becomes brittle and thick.

nails

This disease is increasing in incidence among older adults.

non insulin dependant diabetes

A 68-year-old Alzheimer's patient is wandering up and down the hospital hallway. As the nurse, your first response should be to:

offer toilet assistance

An 84-year-old female patient presents to the emergency department with symptoms of delirium: acute confusion and hallucinations. Her caregiver brought along her current medications. You note that the patient takes 21 different routine medications. As the nurse, you suspect the cause of delirium to be:

polypharmacy

The skin is at risk for this in the older population.

pressure ulcers

Removal of this helps the individual with pneumonia

secretions

A patient has had five children. She is now 70 years old and wears incontinence pads to protect from small amounts of urine loss when coughing. This type of incontinence is called _____ urinary incontinence.

stress

This will help to prevent pressure ulcers.

turn q 2 hours

What is the difference between urge urinary incontinence and functional urinary incontinence?

urge is associated with cystitis, tumors, stones and CNS disorders, characterized by involuntary urine loss with a sudden urge to void. Functional puts the fun , jk functional occurs as a result of the inability or unwillingness to get to the toilet because of physical limitations, depression, or confinement to bed

Standing in one place for long periods of time causes _________________.

venous stasis

A 76-year-old male patient has been active his whole life and exercises regularly. He is admitted to the hospital for a proximal femur fracture he got after tripping at the local gym. During his recovery from a surgical repair, the nurse's care of this patient includes:

vitals, I/O, pain

Biological theories explain:

why the body ages