EAQ Ch. 14 older adult

What may be the reason for decreased mobility of the ribs? Curvature of the thoracic spine Calcification of the costal cartilage Decrease in the respiratory muscle strength Increase in the anteroposterior diameter of thorax

Calcification of the costal cartilage

Which body system is affected in presbyopia? Ears Eyes Smell Taste

Eyes

Which extrinsic factors increase the risk for falls among older adults? Poor lighting Inappropriate footwear Adverse medication reactions Improper use of assistive devices Unfamiliar environment of a hospital room

Poor lighting Inappropriate footwear Improper use of assistive devices Unfamiliar environment of a hospital room

The nurse is teaching a group of older adults. Which principles are helpful in promoting learning in older adults? Sit to the side rather than directly facing the patient. Ask for feedback from the patient. Present one idea or concept at a time. Speak fast and in a loud voice. Use audio and visual cues while teaching.

Use audio and visual cues while teaching. Ask for feedback from the patient. Present one idea or concept at a time.

Which type of elder mistreatment involves desertion of a vulnerable elder at a hospital? Physical abuse Abandonment Caregiver neglect Psychosocial abuse

Abandonment Abandonment may involve desertion by a caregiver of older adults who are unable to protect themselves at a hospital or other public location. Physical abuse refers to the infliction of physical pain such as hitting, beating or slapping. Caregiver neglect refers to failure of providing caregiving activities such as refusal to provide food, water, or clothing. Psychosocial abuse refers to an act that inflicts mental pain or distress such as humiliation and social isolation.

An older adult is in the early stages of Alzheimer's disease. The patient is an accountant by profession. The patient has been forgetful in the last few months and also has difficulty memorizing events or numbers. These symptoms are affecting the patient's occupation. Which clinical presentations would indicate development of dementia in this patient? Altered consciousness Disorientation Slow onset of symptoms Slow progression of symptoms Impairment of recent and remote memory

Slow onset of symptoms Slow progression of symptoms Impairment of recent and remote memory

The nurse is caring for an elderly patient who is having difficulty recalling directions after hospitalization. On assessment, the nurse noticed that hypoxia has intensified the condition. What is the possible psychological condition of the patient? Stress Delirium Dementia Depression

Delirium Difficulty recalling directions may be a sign of delirium. This is an adverse event seen in hospitalized elderly patients. The risk of delirium in these patients is increased by conditions such as hypoxia. Stress is a nonmedical cause that increases the risk of delirium. Difficulty recalling directions is not necessarily a sign of dementia, which is associated with more pervasive memory loss. Depression is not associated with memory loss and is not exacerbated by hypoxia.

While reviewing the x-ray reports of an older patient, the nurse observes curvature of the thoracic spine. What does the nurse document in the patient's health record? Presbyopia Presbycusis Dorsal kyphosis Macular degeneration

Dorsal kyphosis Dorsal kyophosis is curvature of the thoracic spine in which the top of the back appears more rounded than normal. Presbyopia is a progressive decline in the ability of the eyes in older patients. Presbycusis is age-related hearing loss in older patients. Macular degeneration is a disorder of the eyes that results in loss of vision in older patients.

Which condition does the nurse suspect in an older adult patient who has complained of daily hearing decline? Delirium Dementia Presbyopia Presbycusis

Presbycusis

During a home health visit the nurse talks with a patient and family caregiver about the patient's medications. The patient has hypertension and renal disease. Which findings place the patient at risk for an adverse drug event (ADE)? Taking two medications for hypertension Taking a total of eight different medications during the day Having one physician who reviews all medications Patient's health history Involvement of the caregiver in assisting with medication administration

Taking a total of eight different medications during the day Patient's health history

The nurse is assessing an elderly patient who has a history of excessive alcohol use. Which questions asked by the nurse would be most appropriate for the patient? "Do you have history of skipping meals?" "Do you have a family history of dementia?" "Do you have a history of frequent accidents?" "Do you perform daily activities on your own?" "Do you face any difficulty while handling financial issues?"

"Do you have history of skipping meals?" "Do you have a history of frequent accidents?" "Do you face any difficulty while handling financial issues?" Patients who abuse alcohol tend to skip meals and medication. In addition, history of frequent accidents increases the suspicion of alcohol abuse. Patient who abuse alcohol may also have difficulty handling financial issues. Family history of dementia is not associated with alcohol abuse. Conditions such as cardiovascular accident may lead to impaired functional abilities, which create difficulty performing daily activities.

A registered nurse is evaluating the statements of the student nurse regarding reproductive changes that occur in both sexes due to aging. Which statement made by the student nurse indicates a need for further teaching? "The desire to have sex decreases with aging." "Vaginal irritation causes pain during sexual activity." "Lack of lubrication of vaginal mucosa causes irritation." "Production of sperm in men decreases during the third decade of life."

"Production of sperm in men decreases during the third decade of life." Production of sperm declines during the fourth decade of a man's life; that is, it declines at 40 years of age, not at 30 years of age. With increasing age, sexual desire also decreases. A characteristic feature of reproductive change in women is decreased production of estrogen and progesterone. Decreased estrogen and progesterone may cause decreased lubrication of the vaginal mucosa, leading to irritation. Vaginal irritation, which occurs due to lack of lubrication, may result in pain during sexual activity.

The nurse visits a patient at home. Which activities should the nurse assess to determine the patient's ability to perform activities of daily living (ADL),? Bathing Toileting Dressing Shopping Cooking

Bathing Toileting Dressing Shopping and cooking are instrumental activities of daily living (IADL). ADL and IADL are sensitive indicators of health and illness.

The nurse is assessing an older adult with impaired memory. Which are clinical features of dementia that differentiate the case from delirium? Onset of dementia is sudden. Alertness in dementia fluctuates. Judgment is impaired in dementia. Duration of dementia is months to years. Consciousness is unaffected in dementia patient.

Judgment is impaired in dementia. Duration of dementia is months to years. Consciousness is unaffected in dementia patient. Clinical features of dementia include impaired judgment, slow onset, and slow progression of the disease. Dementia is due to gradual degenerative changes in the brain. It may take months to years for dementia to manifest. Consciousness is usually clear in a patient with dementia. Delirium always has an underlying acute cause. In delirium, the onset of the disease is sudden. Alertness levels usually fluctuate in delirium.

The nurse is communicating with older adults about the effects of drugs on older people. After this communication the nurse finds that the older adults avoid adhering to the prescribed dosing schedule. Which is the most likely reason for it? Older adults prefer using herbal medicine. Older adults may forget the proper timing of the medication. Older adults are confused about medicine dosages. Older adults are more prone to the adverse effects of medicines.

Older adults are more prone to the adverse effects of medicines.

While assessing the health of four patients, the nurse discovers one of the patient's findings to be age-related. Which patient supports the nurse's conclusion? Patient A has white sclera. Patient B has yellowing of the lens. Patient C has a decreased sensitivity to glare. Patient D has dilation of pupil in the presence of light.

Patient B has yellowing of the lens. With aging, the crystalline fibers present in the lens stop regenerating and undergo many post-translational changes. These changes make the lens appear opaque and yellowish. Therefore, patient B's finding supports the nurse's conclusion. White sclera is a normal finding, not an age-related change. In older adults, there will be increased sensitivity to glare as an effect of aging. Therefore, the finding of patient C is not a physiological change related to aging. Pupils dilate upon exposure to light. Therefore, patient D's finding is normal.

A 70-year-old patient has been admitted to the medical-surgical unit. The nurse is reviewing the patient's admission information. Which sensory changes is the nurse likely to find in the patient? Presbyopia Presbycusis Changes in proprioception Buildup of cerumen Increased touch sensitivity

Presbyopia Presbycusis Changes in proprioception Buildup of cerumen Aging leads to a number of physiological and psychological changes, including changes in sensory perception. The changes in sensory perception include decreased accommodation to near/far vision (presbyopia), loss of acuity for high-frequency tones (presbycusis), buildup of earwax (cerumen), and decreased awareness of body positioning in space (proprioception). There is often a decrease in touch sensitivity owing to a decreased number of skin receptors.

The registered nurse is teaching about normal gastrointestinal system and abdomen changes in older adults. Which statement by the nurse needs correction? Peristalsis decreases in older adults. The pH of the stomach increases in older adults. Salivary secretion decreases in older adults. The size of the abdomen decreases in older adults.

The size of the abdomen decreases in older adults.

While assessing an older patient, a nurse infers cognitive impairment. Which statements made by the patient's partner help to confirm the inferred condition? "He gets confused between activities." "He is having a problem judging things." "He is unable to remember daily activities." "He is unable to converse properly with family." "He is unable to help my grandchild in calculations."

"He is having a problem judging things." "He is unable to converse properly with family." "He is unable to help my grandchild in calculations." Poor judgment, loss of language skills, and loss of the ability to calculate are associated with cognitive impairment. This may develop due a change in neurotransmitters in the brain and the symptoms may not be related to the normal aging process. Getting confused and experiencing forgetfulness may be associated with normal aging changes.

An older patient complains of the decreased ability to do usual activities. Which type of health care setting deals with such conditions? Home care Hospital care Nursing home Ambulatory care

Ambulatory care Complaints of decreased ability to do usual activities are often signs of anemia and this patient should be admitted to ambulatory care. Home care is provided for older patients who are in late stages of disease such as loss of appetite, heart failure, and neurological issues. Nursing care is provided for older adults with dementia and new illnesses. Hospital care is provided to older patients who are at a risk for delirium.

The nurse sees a 76-year-old in the outpatient clinic. The patient's chief complaint is vision. The patient has really noticed glare in the lights at home; vision is blurred; and the patient is unable to play cards with friends, read, or do needlework. What is this patient experiencing? Presbyopia Disengagement Cataracts Depression

Cataracts

When a patient experiences kyphosis, which should the nurse recognize as a future risk? Decreased bone density in the vertebrae and hips Increased risk for pathological stress fractures in the hips Changes in the configuration of the spine that affect the lungs and thorax Calcification of the bony tissues of the long bones such as in the legs and arm

Changes in the configuration of the spine that affect the lungs and thorax

The nurse has conducted an assessment of a new patient who has come to the medical clinic. The 82-year-old patient has had osteoarthritis for 10 years and diabetes mellitus for 20 years. The patient is alert but becomes easily distracted during the nursing history. The patient recently moved to a new apartment, and the patient's pet beagle died just 2 months ago. Which is this patient most likely experiencing? Dementia Depression Delirium Disengagement

Depression

The nurse is assessing an older patient who attempted suicide twice due to death of his life partner. He has undergone psychotherapy for depression, but the symptoms have not subsided. Which therapy would be beneficial for the patient? Reminiscence Validation therapy Medication therapy Electroconvulsant therapy

Electroconvulsant therapy Older adults may experience late-life depression due to the loss of a life partner, but this is not a normal part of aging. If the patient does not respond to psychotherapy, it indicates the patient has resistant depression. In this case, electroconvulsant therapy is used. Reminiscence is the recollection of the past, which is used to understand and resolve present conflicts. Validation therapy is an alternative approach used to treat older adults who are confused about the present. Medication therapy is used to treat clinical depression.

The nurse is caring for an elderly patient who has dementia. How can the nurse help to maintain the nutritional status of the patient? Monitor food intake. Routinely monitor weight. Serve food that is easy to eat. Provide assistance with eating. Eliminate sugar and salt from the diet.

Monitor food intake. Routinely monitor weight. Serve food that is easy to eat. Provide assistance with eating.

The caregiver of an older adult patient reports, "My father, in spite of turning up the volume on the radio and television, complains that he is unable to hear." Which condition should the nurse suspect in the patient? Kyphosis Keratoses Presbyopia Presbycusis

Presbycusis

Reminiscence strategies are used to evaluate an older adult patient's memory. What do these strategies do? They produce a positive mood. They reduce the patient's anxiety. They stimulate memory chains through associations. They allow evaluation of a patient's judgment and general knowledge.

They stimulate memory chains through associations.

A patient has presbyopia. Which visual manifestation would most likely be present upon examination of the patient? Difficulty to distinguish between blues and greens Difficulty to distinguish between colors such as blue and black Difficulty with vision when moving from bright to dark environments Decline in the ability of the eyes to accommodate from near to far vision

Decline in the ability of the eyes to accommodate from near to far vision

The nurse is caring for an elderly patient who is diagnosed with heart failure. After a week the nurse notices patient behavior that suggests delirium. What does the nurse suspect to be a cause of the delirium? Dehydration Malnutrition Immobilization General fatigue Sleep deprivation

Dehydration Immobilization Sleep deprivation In an acute care setting, an older adult is at risk of developing delirium, which can occur when the patient is dehydrated, immobilized, and has disturbed sleep, affecting cognitive function. Decreased appetite due to medications and certain diagnostic procedures may lead to malnutrition, not delirium. General fatigue may result in immobilization of a patient.

Pain is a symptom and a sensation of distress. Which are consequences of persistent pain? Depression Changes in gait Sleep difficulties Impaired cognition Fear of using analgesics

Depression Changes in gait Sleep difficulties

During a home health visit the nurse talks with a patient and family caregiver about the patient's medications. The patient has hypertension and renal disease. Which findings place the patient at risk for an adverse drug event (ADE)? Taking two medications for hypertension Taking a total of eight different medications during the day Having one physician who reviews all medications Patient's health history Involvement of the caregiver in assisting with medication administration

Taking a total of eight different medications during the day Patient's health history The patient is at risk for an adverse drug event (ADE) because of polypharmacy and a history of renal disease, which affects drug excretion. Taking two medications for hypertension is common. Having one physician review all medications and involving a family caregiver are desirable and are safety factors for preventing ADEs.

Which behaviors are associated with delirium? The patient gives up without trying any task. The patient is distracted from the task assigned. The patient does not care to answer the questions asked. The patient frequently asks for feedback on performance. The patient makes numerous errors while performing any activity.

The patient is distracted from the task assigned. The patient makes numerous errors while performing any activity. Delirium is a serious disturbance in a person's mental ability that results in confusion. A patient with delirium gets distracted from the work assigned because of mental confusion. Disturbed mental ability results in numerous errors while performing any activity. A patient with depression is preoccupied with personal thoughts and gives up without trying any task because of self-neglect. A patient with depression is preoccupied with personal thoughts and does not care to answer questions that are asked. A patient with dementia frequently asks for feedback on performance because of poor judgment ability.

A family member is considering having the mother placed in a nursing center. The nurse has talked with the family before and knows that this is a difficult decision. Which criteria should the nurse recommend in choosing a nursing center? The center should be clean, and rooms should look like hospital rooms. There should be adequate staffing on all shifts. Social activities should be available for all residents. Three meals should be served daily with a set menu and serving schedule. Family involvement in care planning and assisting with physical care is necessary.

There should be adequate staffing on all shifts. Social activities should be available for all residents. Family involvement in care planning and assisting with physical care is necessary.

While caring for an older patient with anxiety, the nurse finds that the patient insists that the date is different from the actual date. The nurse refrains from correcting the patient. Which supporting intervention is the nurse implementing? Reminiscence Touch Therapy Validation therapy Therapeutic communication

Validation therapy

The nurse is caring for an elderly patient diagnosed with Alzheimer's disease. Which intervention would help reduce the patient's confusion? Reminiscence Touch therapy Validation therapy Reality orientation

Validation therapy Validation therapy is beneficial for older adults who are in a confused state, as is common with Alzheimer's disease. It involves accepting and not arguing with patient statements, even if they are incorrect. Reminiscence as therapy involves recollection of the past to help the patient understand the present situation and resolve current conflicts. Touch is a therapeutic tool that is beneficial in older adults to provide physical and emotional comfort when performing any type of procedure. Reality orientation is a communication technique that helps in restore the sense of reality in an older adult.

An older adult is unable to distinguish between the colors blue and black. Which is the most likely cause for this condition? A hereditary syndrome Malnourishment A mental disorder Lens discoloration

Lens discoloration

The home health nurse is performing an initial assessment on an elderly patient. Which physiological changes should the nurse anticipate as being normal for an elderly patient? Decreased saliva production Loss of skin elasticity Disorientation Loss of visual acuity Increased blood pressure

Loss of visual acuity Increased blood pressure Decreased saliva production Loss of skin elasticity

The nurse is assessing an elderly patient with a hip fracture. Which questions asked by the nurse help assess the intrinsic risk factors for a fall? "Did you walk in slippery area?" "Do you work in poor lighting?" "Do you have impaired vision?" "Are you on medication for pain?" "Are you on medication for seizures?"

"Do you have impaired vision?" "Are you on medication for pain?" "Are you on medication for seizures?" A patient with impaired vision may have frequent falls, which can lead to fractures. Drowsiness is the adverse reaction of pain medications such as opioids. So, patient on opioid medications should be cautious. Similarly, a patient on seizure medications such as anticonvulsants should be cautious to prevent falls, because anticonvulsants can also cause drowsiness. These are some of the intrinsic risk factors of falls. Walking in a slippery area and working in poor lighting may also increase the risk of falls, but these are extrinsic risk factors.

Which nursing interventions would be beneficial for older adult patients who are diagnosed with chronic obstructive lung disease (COPD)? Assessing for bacterial infection Monitoring blood pressure frequently Placing a feather pillow under the head Monitoring changes in peripheral pulses Monitoring respirations and breath sounds

Assessing for bacterial infection Monitoring respirations and breath sounds Older adult patients with chronic obstructive lung disease are at higher risk of bacterial and viral infection. Therefore, the nurse needs to monitor for bacterial infection. Patients with chronic obstructive lung disease may have apnea. Therefore, the nurse needs to monitor respirations and breath sounds. Frequent monitoring of blood pressure would not be of benefit for a patient with COPD. Keeping a feather pillow under the head of the patient can precipitate allergic respiratory reactions that may exaggerate the condition. Monitoring changes in peripheral pulses would be beneficial for the patient with heart and vascular disorders, not COPD.

Which statement is true regarding delirium? The onset of delirium is insidious. Disturbed sleep/wake cycle is disturbed. The patient with delirium may have normal alertness. Progression of the delirium is slow over months and years.

Disturbed sleep/wake cycle is disturbed.

An older adult has had several bouts of diarrhea. The nurse finds that the patient is exhibiting a sudden onset of altered behavior. Which findings in the patient will help the nurse diagnose delirium? Clear perception Clear consciousness Fluctuation in alertness Impairment of remote memory Worsening of symptoms during the night

Fluctuation in alertness Worsening of symptoms during the night

An older adult wishes to start an exercise regimen. Which safety advice should the nurse provide this patient? Go slow. Wear supportive shoes. Do not drink water before exercise. Exercise with a partner. Avoid exercising outdoors in extreme weather.

Go slow. Wear supportive shoes. Exercise with a partner. Avoid exercising outdoors in extreme weather.

Which are considered risk factors for falls in older adults? Osteoporosis Airway blockages Impaired hearing Alterations in bladder function Cognitive impairment Peripheral neuropathy

Osteoporosis Alterations in bladder function Cognitive impairment Peripheral neuropathy

After reviewing health records of four older patients, the nurse suspects normal age-related physiological changes in one patient. Which patient's lab findings may the nurse observe? Patient 1 has decreased prostate size, decreased sensitivity to glare, and increased firm erections. Patient 2 has increased fat tissue, decreased thymus size, and increased anti-inflammatory hormones. Patient 3 has narrowing of blood vessels, thickening of vessel lumen, and increased calcification of the heart. Patient 4 has increased thyroid secretions, increased T-cell function, and decreased systolic blood pressure.

Patient 2 has increased fat tissue, decreased thymus size, and increased anti-inflammatory hormones. In older patients, the amount of fat tissue increases, the thymus gland decreases in size and volume, and anti-inflammatory response increases. Therefore, patient 2 has normal age-related changes. In older patients, the size of the prostate increases, sensitivity to glare increases, and firm erections are fewer. The blood vessels narrow, the vessel lumen thickens, and there is decreased calcification of heart, decreased thyroid secretions, decreased T-cell function, and increased systolic blood pressure in older patients. Therefore, the findings in Patient 1, Patient 3, and Patient 4 are not age-related changes.

An older adult has had several bouts of diarrhea. The nurse finds that the patient is exhibiting a sudden onset of altered behavior. The patient's hearing and vision are impaired. Which interventions should the nurse perform to provide supportive care to the patient? Tell the patient to avoid new surroundings. Suggest the use of glasses to correct vision. Instruct the patient to fast until the diarrhea subsides. Encourage fluid restriction due to the risk of further diarrhea. Tell the patient not to use a hearing aid due to the risk of auditory hallucinations.

Tell the patient to avoid new surroundings. Suggest the use of glasses to correct vision.

The nurse is assessing data obtained from the physical examination of a 70-year-old, female patient. Which observations may be considered abnormal? Hard breasts Seborrheic lesions Dorsal kyphosis Hypertension Presbyopia

Hard breasts Hypertension As a woman ages, estrogen secretion diminishes, causing the milk ducts to be replaced by fat tissues, making the breasts less firm. Breast hardness in older patients may be a symptom of breast cancer. Hypertension is not an age-related change; it is an abnormal finding and may predispose the patient to other cardiovascular diseases. Seborrheic lesions, dorsal kyphosis, and presbyopia are age-related changes. Seborrheic lesions appear due to long years of exposure to sun. Dorsal kyphosis is a result of age-related vertebral changes caused by osteoporosis. Presbyopia is a progressive decline in the ability of the eyes to accommodate from near to far vision.

In which health care setting would the nurse be most likely to find an older adult with chronic dehydration exacerbated by acute illness? Home care Nursing home care Hospital care Ambulatory care

Hospital care In a hospital care setting, an older adult may experience chronic dehydration exacerbated by acute illness; this could occur due to medications and diagnostic procedures that limit the intake of fluids. In a home care setting, older adults with late-stage heart disease should be monitored for loss of appetite. In a nursing home setting, patients should be observed for a decline in functional ability, which may indicate the onset of illness. An older patient who seeks ambulatory care with a complaint of fatigue and limited ability to perform normal activities may have thyroid problems, anemia, or cardiac problems.

Selecting a nursing center is an important process for a patient who requires health care. What are the criteria for selecting a nursing center? It should provide quality care. It should offer quality food and mealtime choices. It should have the same kind of rooms with no opportunity for personalization. It should have staff that focuses on completing tasks. It should facilitate active communication from the staff to the patient and family.

It should facilitate active communication from the staff to the patient and family. It should provide quality care. It should offer quality food and mealtime choices. It should have the same kind of rooms with no opportunity for personalization.

The nurse is teaching an elderly patient about care management for safe and effective care. Which teaching strategies will likely lead to effective learning in an older adult? Scheduling the teaching session in the evening Pausing frequently before providing any new information Using the teaching session to provide detailed information Ensuring the presence of a family member during the teaching session Using lay terms while providing medical information to the patient

Pausing frequently before providing any new information Ensuring the presence of a family member during the teaching session Using lay terms while providing medical information to the patient It is important to pause frequently after presenting new concepts or information because older adults need time to process the new information. The nurse should encourage the older adult to invite a family member or friend to ensure active participation of the older adult in the teaching session. Medical terminology is hard to understand and should be avoided when teaching older patients. It is important to use lay terms because it helps ensure proper understanding of the information by the older adult. The teaching session for an older patient should be scheduled in midmorning because energy levels are more likely to be high. By evening, older adults are often tired and unable to concentrate on the teaching provided to them. It is important to limit the message to a few essential key points and to avoid extraneous information in order to minimize distractions and help the older adult focus during the interaction.

The nurse is working with an older adult after an acute hospitalization. The nurse's goal is to help this person be more in touch with time, place, and person. Which technique should the nurse try? Reminiscence Validation therapy Reality orientation Body image interventions

Reality orientation Reality orientation is a communication technique that can help restore a sense of reality, improve level of awareness, promote socialization, elevate independent functioning, and minimize confusion. Reminiscence recalls the past to bring meaning to the present. Validation is used with confused patients. Body image intervention is not indicated in this case.

An elderly patient reports that he is unable to see bright lights, far objects appear blurred, and he is unable to read the newspaper as before. After examining the eyes, the nurse finds the patient's lens to be opaque. What does the nurse suspect in the patient? Cataract Presbyopia Diabetic retinopathy Macular degeneration

Cataract Sensitivity towards bright lights is called glare. Opacity of the lens indicates loss of transparency of the lens. Loss of transparency of the lens, blurred vision, increased sensitivity to glare, and gradual loss of vision are the clinical manifestations of cataract. Presbyopia is a condition, wherein the eye is unable to focus on near objects; though presbyopia is manifested by discoloration of the lens, it is not associated with blurred vision. Diabetic retinopathy has no early signs and symptoms. Macular degeneration is manifested by accumulation of extracellular material on the retina

A patient has diagnosed presbycusis. Which symptom is most likely present in the patient? Impairment in the ability to hear high-pitched sounds Difficulty in distinguishing between dark colors such as blue and black Difficulty in vision when moving from bright to dark environments Decline in the ability of the eyes to accommodate from near to far vision

Impairment in the ability to hear high-pitched sounds Common age-related change in auditory acuity is called presbycusis. Presbycusis affects the ability to hear high-pitched sounds and sibilant consonants such as s, sh, and ch. Difficulty in distinguishing between dark colors such as blue and black occurs due to changes in color vision and discoloration of the lens. Difficulty in vision when moving from bright to dark environments occurs due to a reduction in the ability to adapt to abrupt changes from dark to light areas. Decline in the ability of the eyes to accommodate from near to far vision is known as presbyopia.

The nurse is assessing an anxious older adult who has recently started to make mistakes regarding date and time. What is the best approach by the nurse in this situation? Let the patient continue to think in his or her own way. Insist that the patient recognize the correct date and time. Use touch intervention to reduce anxiety in the patient. Inform the patient that this is an outcome of reminiscence.

Let the patient continue to think in his or her own way. The anxious nature of the patient and mistaking the date and time are possible signs of dementia. Therefore, the patient may benefit from validation therapy, which involves letting the older adult continue to think in his or her own way. Older adults with dementia are more likely to become agitated if the nurse insists on correcting them. Use of touch therapy is usually done to provide emotional comfort; it does not address the patient's confusion. Reminiscence is a therapeutic approach that involves recalling the past to resolve present conflicts. Therefore, mistaking the present date and time is not an outcome of reminiscence.

An older adult is in the early stages of Alzheimer's disease. The patient is an accountant by profession and has been forgetful in the last few months. The patient also has difficulty memorizing events or numbers. Due to the decline in cognitive function, the patient finds it difficult to perform the activities of daily living (ADLs). Which supportive measures would help in rehabilitating the patient? Make the environment safe for the patient to move in. Limit choices in dressing and eating. Encourage aggressive behavior. Institute measures to correct underlying physiological alterations. Emphasize aggressive drug treatment without concern for adverse reactions.

Make the environment safe for the patient to move in. Limit choices in dressing and eating. Institute measures to correct underlying physiological alterations.

Reality orientation is a communication technique. What are the purposes of reality orientation? Minimizing confusion Promoting socialization Restoring a sense of reality Improving the level of awareness Providing assistance for functioning

Minimizing confusion Promoting socialization Restoring a sense of reality Improving the level of awareness Reality orientation technique makes an older adult more aware of time, place, and person. The purposes of reality orientation include minimizing confusion, promoting socialization, restoring a sense of reality, and improving the level of awareness. Orientation to time, place, and person helps to decrease confusion and helps the patient communicate effectively with others. Orientation to time, place, and person restores a sense of reality, thus increasing awareness in the patient. It does not provide assistance for functioning.

The nurse is caring for an older adult who has cognitive impairment. Which interventions are necessary to enhance quality of life and maximize functional performance? Provide unconditional positive regard. Limit fluid intake. Activate bed and chair alarms. Keep a routine and limit choices for dressing. Be vigilant for drug reactions and interactions.

Provide unconditional positive regard. Activate bed and chair alarms. Keep a routine and limit choices for dressing. Be vigilant for drug reactions and interactions. The nursing care should be individualized for older adults with cognitive impairment. Providing positive regard promotes self-respect in the patient. Bed and chair alarms remind the patient to call for help when needed. A change in routine or too many options to choose from may confuse the patient. Drug reactions and interactions are more common in older adults due to slow metabolism of drugs. Fluid intake should be encouraged, because dehydration can occur quickly in the patient.