Chapter 5: Chronic Illness and Older Adults

The nurse performs a comprehensive geriatric assessment of a patient who is being assessed for admission to an assisted living facility. Which question is the most important for the nurse to ask?

"Are you able to prepare your own meals?"

Which statement, if made by an older adult patient, would be of most concern to the nurse?

"I don't go on daily walks anymore since I had pneumonia 3 months ago."

Which nursing actions will the nurse take to assess for possible malnutrition in an older adult patient (select all that apply)?

-Observe for depression. -Review laboratory results. -Assess teeth and oral mucosa. -Ask about transportation needs.

Which patient is most likely to need long-term nursing care management?

63-year-old with bilateral knee osteoarthritis who weighs 350 lb (159 kg)

An older patient complains of having "no energy" and feeling increasingly weak. The patient has had a 12-pound weight loss over the last year. Which action should the nurse take initially?

Ask the patient about daily dietary intake.

An older patient is hospitalized with pneumonia. Which intervention should the nurse implement to provide optimal care for this patient?

Consider the preadmission functional abilities when setting patient goals.

The nurse cares for an older adult patient who lives in a rural area. Which intervention should the nurse plan to implement to best meet this patient's needs?

Ensure transportation to appointments with the health care provider.

A patient who has just moved to a long-term care facility has a nursing diagnosis of relocation stress syndrome. Which action should the nurse include in the plan of care?

Have staff members write notes welcoming the patient to the facility.

An older adult patient presents with a broken arm and visible scattered bruises healing at different stages. Which action should the nurse take first?

Have the family member stay in the waiting area while the patient is assessed.

Which nursing action will be most helpful in decreasing the risk for drug-drug interactions in an older adult?

Have the patient bring all medications, supplements, and herbs to each appointment.

The nurse assesses an older patient who takes diuretics and has a possible urinary tract infection (UTI). Which action should the nurse take first?

Invite the patient to use the bathroom.

The family of an older patient with chronic health problems and increasing weakness is considering placement in a long-term care (LTC) facility. Which action by the nurse will be most helpful in assisting the patient to make this transition?

Obtain the patient's input about the choice of a LTC facility.

The nurse admits an acutely ill, older patient to the hospital. Which action should the nurse take first?

Perform the physical assessment before interviewing the patient.

The nurse cares for an alert, homeless older adult patient who was admitted to the hospital with a chronic foot infection. Which intervention is the most appropriate for the nurse to include in the discharge plan for this patient?

Refer the patient to social services for further assessment.

An older patient who takes multiple medications for chronic cardiac and pulmonary diseases is alert and lives with a daughter who works during the day. During a clinic visit, the patient verbalizes to the nurse that she has a strained relationship with her daughter and does not enjoy being alone all day. Which nursing diagnosis should the nurse assign as the priority for this patient?

Risk for injury related to drug interactions

When caring for an older patient with hypertension who has been hospitalized after a transient ischemic (TIA), which topic is the most important for the nurse to include in the discharge teaching?

Symptoms indicating that the patient should contact the health care provider

The nurse manages the care of older adults in an adult health day care center. Which action can the nurse delegate to unlicensed assistive personnel (UAP)?

Take blood pressures daily and document in individual patient records.

The home health nurse visits an older patient with mild forgetfulness. The nurse is most concerned if which information is obtained?

The patient has lost 10 pounds (4.5 kg) during the last month.

When completing an admission assessment on an older adult, the nurse gives the patient a high fall risk score. Which action should the nurse take first?

Use a bed alarm system on the patient's bed.

The nurse plans to complete a thorough assessment of an older patient. Which method should the nurse use to gather the most complete information?

Use a geriatric assessment instrument to evaluate the patient.

The home health nurse cares for an older adult patient who lives alone and takes several different prescribed medications for chronic health problems. Which intervention, if implemented by the nurse, would best encourage medication compliance?

Use a marked pillbox to set up the patient's medications.