AH Theory I: Ch. 11 Healthcare of the Older Adult

An older adult female patient tells the nurse, "I have lost an inch of height and have a hump on my back. What can I do about this?" What is the best response by the nurse?

"In order to prevent further bone loss, eat a diet high in calcium and low in phosphorus." To promote musculoskeletal health, the nurse should tell the patient to do the following: exercise regularly; eat a high-calcium diet; limit phosphorus intake; and take calcium and vitamin D supplements as prescribed.

Which of the following older adults is at highest risk for medication-related toxicity?

A 65-year-old with renal insufficiency Many medications are excreted through the kidneys; therefore, the patient with the highest risk for drug toxicity is the patient with renal insufficiency. An older adult with chronic diarrhea has increased gastric motility which may decrease the absorption of the medication and not increase the risk of toxicity. A BMI of 22.6 is within the normal range; therefore, the patient is not at as high risk as someone that is underweight or overweight. Vascular changes do happen with diabetes mellitus, which may increase the risk for drug toxicity. Because the patient has been diagnosed with diabetes for only 2 years, vascular changes are usually not significant enough to put the patient at a higher risk than someone with known renal insufficiency.

After teaching a group of nursing students about living arrangements for older adults, the instructor determines that the teaching was successful when the group identifies which housing option as used by most older adults?

Home More than 90% of older adults live in the community, with 80% of those 65 years or older living in their own homes. Only a small percentage reside in nursing homes and a comparable percentage live in some type of senior housing.

An elderly client reports fatigue with increased activity. He states that he walks 30 minutes five times each week. The nurse assesses the resting heart rate as 72 beats per minute; 10 minutes after walking, the client's heart rate is 102 beats per minute. The nurse instructs the client to

Continue to walk at his current level. Elderly clients may report fatigue with increased activity as a result of a slower heart rate recovery, which may be a physiological response to aging. An appropriate nursing intervention is to educate the client to exercise regularly but also to pace activities. The nurse does not want to tell the client not to exercise, to walk faster, or to decrease frequency.

Which is an age-related change in the respiratory system?

Decreased gas exchange Age-related changes associated with the respiratory system include decreased gas exchange. Age-related changes associated with the cardiovascular system include increased blood pressure. Changes that occur in the musculoskeletal system include loss of muscle strength and size. Difficulty swallowing occurs as an age-related change associated with the gastrointestinal system.

The plan of care for a patient with advanced Alzheimer's disease includes the nursing diagnosis of risk for injury. The nurse has identified this nursing diagnosis most likely as related to which of the following?

Impaired memory Patients with Alzheimer's disease are at high risk for injury because they have impaired memory and poor judgment. They also exhibit impulsivity, which increases their risk. Maintaining a safe environment takes top priority. Communication difficulties could be the basis for several nursing diagnoses such as impaired verbal communication, powerlessness, and impaired social interaction. Separation from others could lead to social isolation, impaired social interaction, and social isolation. Personality changes may lead to a risk for self- or other directed violence, chronic low self-esteem, and risk for suicide

An elderly client reports that he feels like he voids frequently during the day and at night but cannot empty his bladder. The nurse instructs the client to

Limit ingestion of caffeinated beverages. Symptoms that the client describes may be indicative of benign prostatic hypertrophy. The client should limit caffeinated beverages. He does not want to decrease fluid intake; doing so may increase his susceptibility to urinary tract infections. He needs to void frequently and not wait long periods between voiding. The client also should limit his alcohol intake, preferably decreasing it.

What is a nurse's role in providing home care for a patient with Alzheimer's disease?

Provide emotional and physical support. Home health care nurses provide emotional support and intervene if family caregivers become overburdened. The nurse also instructs the family about physical care, the disease process, and treatment. Administering IV or supporting patients with household errands is not a relevant role for a home nurse. The nurse should provide education about safety, saying that the patient with Alzheimer's disease should not drive, but contacting the licensing department is not the nurse's responsibility.

The nurse is attempting to take vital signs of an older adult hospitalized following knee surgery. The patient continuously yells, "It's 1999 and you are going to hurt me." What action should the nurse do first?

Reorient the patient. The first action that should be taken by the nurse is to reorient the patient. Hospitalized older adults are at risk for disorientation and confusion. Although the nurse will still need to take the vital signs and assess for infection, reorienting the patient remains the first action. If the patient can be reoriented, then the nurse may be able to complete the other actions without difficulty or potential harm to the patient. The nurse may need to notify the physician if the patient is unable to be oriented or if there are abnormalities with the assessment.

When assessing the older adult, the nurse anticipates an increase in which component of the respiratory status?

Residual lung volume With an increase in residual lung volume the patient experiences fatigue and breathlessness with sustained activity. The nurse anticipates decreased vital capacity. The nurse anticipates decreased gas exchange and diffusing capacity resulting in impaired healing of tissues due to decreased oxygenation. The nurse anticipates difficulty coughing up secretions due to decreased cough efficiency.