Funds- Care of the Older Client

The nurse is planning to feed an older client who is at risk for aspiration of food. During the meal, how should the nurse position the client? 1. upright in a chair 2. on the left side in the bed 3. on the right side in the bed 4. in a low fowler's position, with the legs elevated

1 Rationale: it is preferable to get clients out of bed and sitting in a chair for meals. this position facilitates chewing and swallowing and prevents the reflux of stomach contents and aspiration.

The nurse should implement which activity to promote reminiscence among older clients? 1. having storytelling hours 2. setting up pet therapy sessions 3. displaying calendars and clocks 4. encouraging client participation in a pottery class

1 Rationale: clients who like to retell stories or to describe past events need to be provided with the opportunity to do so. this phenomenon is called life review or reminiscence. in a sense, it is a way for older clients to relive and restructure life experiences, and it is a part of achieving ego identity.

Which data indicate to the nurse that a client may be experiencing ineffective coping following the loss of her spouse? 1. constantly neglects personal grooming 2. visits her husbands grave once a month 3. visits the senior citizens once a month 4. frequently looks at snapshots of her husband and family

1 Rationale: coping mechanisms are behaviors that are used to decrease stress and anxiety. in response to a death, ineffective coping is manifested by an extreme behavior that in so instances may be harmful to the individual physically, psychologically, or both. option 1 is indicative of a behavior that identifies an ineffective coping behavior as part of the grieving process

The nurse is preparing to communicate with an older client who is hearing impaired. Which intervention should be implemented initially? 1. stand in front of the client 2. exaggerate the lip movements 3. obtain a sign language interpreter 4. pantomime and write the client notes

1 Rationale: the nurse would ensure that the hearing impaired client can see the nurse when the nurse is speaking by providing adequate lighting and standing in front of the client. the nurse should enunciate words clearly but not exaggerate lip movements. if the client is profoundly hearing impaired and uses signing, a sign language interpreter should be obtained. if a client cannot understand by reading lips, the nurse would try using gestures, pantomiming, or writing notes

The nurse should plan which to encourage autonomy in the client who is a resident in a long term care facility? 1. choosing his meals 2. decorating his room 3. scheduling his barber appointments 4. allowing the client to choose social activities

4 Rationale: autonomy is the personal freedom to direct ones own life as long as it does not impinge on the rights of others. an autonomous person is capable of rational thought. this individual can identify problems, search for alternatives, and choose solutions that allow for continued personal freedom as long as the rights and property of others are not harmed. the loss of autonomy-and, therefore, independence- is a very real fear among older clients

An older client has been prescribed digoxin (Lanoxin). The nurse understands that which age related change would place the client at risk for digoxin toxicity? 1. decreased cough efficiency and vital capacity 2. decreased salivation and GI motility 3. decreased muscle strength and loss of bone density 4. decreased lean body mass and glomerular filtration rate

4 Rationale: the older client is at risk for medication toxicity because of decreased lean body mass and an age associated decreased glomerular filtration rate. although options 1, 2, and 3 identify age related changes that occur in the older client, they are not specifically associated with this risk

When the nurse is collecting data from the older adult, which findings should be considered normal physiological changes? SATA 1. increased heart rate 2. decline in visual acuity 3. decreased resp rate 4. decline in long term memory 5. increased susceptibility to UTI's 6. increased incidence of awakening after sleep onset

2, 5, 6 Rationale: anatomical changes to the eye affect the individual's visual ability, which leads to potential problems with activities of daily living. light adaptation and visual fields are reduced. resp rates are usually unchanged, the heart rate decreases, and the heart valves thicken. age related changes that affect the Urinary tract increase in an older client's susceptibility to UTI's. short term memory may decline with age, but long term memory is usually maintained. changes in sleep patterns are consistent, age related changes. older persons experience an increased incidence of awakening after sleep onset

Which client is most likely at risk to become a victim of elder abuse? 1. a 75 year old man with moderate hypertension 2. a 68 year old man with newly diagnosed cataracts 3. a 90 year old woman with advanced parkinson's disease 4. a 70 year old woman with early diagnosed lyme disease

3 Rationale: elder abuse is widespread and occurs among all subgroups of the population. it includes physical and psychological abuse, the misuse of property, and the violation of rights. the typical abuse victim is a woman of advanced age with few social contacts and at least one physical or mental impairment that limits her ability to perform activities of daily living. in addition, the client usually lives alone or with the abuser and depends on the abuser for care

Which intervention should be implemented for the older client with presbycusis who has a hearing loss? 1. speak louder 2. speak more slowly 3. use low pitched tones 4. use high pitched tones

3 Rationale: presbycusis refers to the age related, irreversible, degenerative changes of the inner ear that lead to decreased hearing acuity. as a result of these changes, the older client has a decreased response to high frequency sounds. low pitched tones of voice are more easily heard and interpreted by the older client. speaking softly or slowly is not helpful

The nurse is providing an education class to healthy older adults. Which exercise will best promote health maintenance? 1. gardening every day for an hour 2. sculpting once a week for 40 minutes 3. cycling three times a week for 20 minutes 4. walking three to five times a week for 30 mins

4 Rationale: exercise and activity are essential for health promotion and maintenance in the older adult and for achieving an optimal level of functioning. approx half of the physical deterioration of the older client is caused by disuse rather than by the aging process or disease. one of the best exercises for an older adult is walking, with the goal of progressing to 30 min sessions three to five times each week. swimming and dancing are also beneficial