Chapter 11 PrepU

When administering medications to an older adult patient, which medication does the nurse understand may remain in the body longer due to increased body fat?

- Barbiturates >Proportion of body fat increases with age, resulting in increased ability to store fat-soluble medications, including barbiturates; this causes drug accumulation, prolonged storage, and delayed excretion. The other medications listed are not fat-soluble.

A nurse is preparing to assess an older adult patient. Which approach would the nurse most likely use?

-Functional assessment >Although various approaches may be used, a functional assessment is the most common framework or approach used to assess elderly patients because it addresses age-related changes as well as additional risk factors such as disease and effects of medications, which can have a negative impact on function.

The nurse is assisting an older adult patient with dietary planning. The nurse emphasizes the importance of adequate intake of fruits, vegetables, and fish. What should the patient's daily carbohydrate intake be?

-50%-60%

A nurse is assessing an older adult for depression using the Geriatric Depression Scale. Which question would the nurse ask first?

-Are you basically satisfied with your life? >When using the Geriatric Depression Scale, the nurse would first question the patient about being satisfied with life. Then the nurse would continue the assessment, asking if the patient feels his or her life is empty, if the patient often gets bored, and if the patient is in good spirits most of the time.

A nurse is preparing a presentation for a local senior center about the health status of older adults. Which of the following would the nurse include as the major causes of death in those older than 65 years? Select all that apply.

-Heart Disease -Cancer

The nurse is preparing an elderly hospitalized client for discharge to home within the hour. What should be the priority for the nurse?

-Assess the need for pneumococcal and influenza vaccinations. >Activities that help elderly people maintain respiratory function include pneumococcal and yearly influenza immunizations. The nurse is to ensure the safety of the client. It is unsafe to administer an intravenous pain medication and then immediately discharge the client. Elderly clients should limit sun exposure to 10 to 15 minutes daily, and avoid heavy activity after eating to prevent indigestion.

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.

Students are reviewing information about age-related changes in the older adult. They demonstrate a need for additional study when they identify which of the following as an age-related change in the respiratory system?

-Decreased residual lung volume

The nurse is assessing a 78-year-old woman and suspects that the patient may have age-related macular degeneration. Which assessment finding would most likely support this suspicion?

-Diminished color perception >Age-related macular degeneration affects central vision, not peripheral vision. It also affects color perception and fine detail discrimination, affecting common visual skills such as reading, driving, and seeing faces.

When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal?

-Feeling of fullness

An elderly client exhibits blood pressure of 110/76 while prone, 100/72 sitting, and 92/64 standing. The nurse instructs the client to

-Ingest five or six small meals each day. >A client who experiences orthostatic hypotension should eat five or six small meals to minimize hypotension that can occur after large meals. The client should avoid straining when having a bowel movement. A stool softener would be useful. Hot showers and whirlpools should be avoided.

An elderly female client has been taking prednisone for breathing problems for many years. The nurse notes that the client's current height is 64 inches. Two years ago, her height was 66 inches. The nurse assesses this loss in height is most likely the result of

-Loss of bone density

Students are reviewing information about visual changes and conditions associated with aging. The group demonstrates understanding of the information when they identify which condition as the major cause of vision loss in the elderly?

-Macular degeneration

An elderly client recovering from a hip repair becomes disoriented and tries to get out of bed frequently. The client states, "I forget I am in the hospital." The best nursing intervention is to

-Post a sign stating "You are in the hospital" at the client's eye level.

Which refers to the decrease in lens flexibility that occurs with age, resulting in the near point of focus getting farther away?

-Presbyopia >Presbyopia usually begins in the fifth decade of life, when reading glasses are required to magnify objects. Presbycusis refers to age-related hearing loss. Cataract is the development of opacity of the eye lens. Glaucoma is a disease characterized by increased intraocular pressure.

The nurse is assessing sleep habits of an elderly client who reports difficulty falling asleep and staying asleep. The nurse intervenes when the client reports he

-Reads in bed before going to sleep

A female elderly client tells the nurse she experiences vague pain during sexual intercourse with her spouse. It is best for the nurse to

-Refer the client to a gynecologist for evaluation.

A nurse is completing the history and physical examination of an older adult patient. When assessing the pateint's eyes, which of the following would the nurse document as a normal finding?

-Reports of being sensitive to glare

After teaching students about age-related changes in the sense of taste in older adults, the instructor determines that teaching was successful when the students identify which taste as being most affected?

-Sweet

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?

-The client's own home

A client with Alzheimer's disease is being treated for malnutrition and dehydration. The nurse decides to place him closer to the nurses' station because of his tendency to:

-Wander