**Socrative - 1. Intro Unit
A nurse is teaching an older patient about the signs and symptoms of a myocardial infarction. Which statement by the patient would indicate that the teaching was effective? "The pain in my chest may last a long time." "I will feel like I have an elephant sitting on the center of my chest." "The chest pain will be sharp and over the center of my chest." "The pain may not be severe and may not be in my chest."
"The pain may not be severe and may not be in my chest." Myocardial infarction in older adults is often associated with ST-segment depression rather than ST elevation. Sensation of chest pain may be altered and may be less intense and of shorter duration. Other atypical symptoms may include dyspnea, confusion, and failure to thrive, which results in unrecognized signs and symptoms of cardiac problems and delays in diagnosis and treatment
Which of the following can be a normal assessment finding for an older patient? Asymptomatic dysrhythmias Decreased urine output Increased respiratory effort Difficulty problem solving
Asymptomatic dysrhythmias The incidence of asymptomatic cardiac dysrhythmias increases in older patients. The most common dysrhythmia is the premature ventricular contraction. Other common types are atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia and atrioventricular conduction disturbances. All of the other findings are abnormal.
An older patient is starting a new medication that is metabolized in the liver and excreted by the kidneys. Which is the best assessment to monitor the patient's ability to tolerate the medication? Liver function tests Drug side effects experienced by the patient Kidney function tests Therapeutic drug levels
Drug side effects experienced by the patient Adverse drug effects and medication interactions may be related to pharmacokinetics or the manner in which the body absorbs, distributes, metabolizes, and excretes a drug. The aging process is associated with changes in gastric acid secretion, which can alter ionization or solubility of a drug and hence its absorption. Medication distribution depends on body composition and on physiochemical drug properties. With advancing age, a patient's fat content increases, lean body mass decreases, and total body water decreases, which can alter drug disposition.
A 68-year-old patient has been admitted to the coronary care unit after an inferior myocardial infarction. Age-related changes in myocardial pumping ability may be evidenced by increased contractility decreased contractility decreased left ventricle afterload increased cardiac output
decreased contractility Collagen is the principal noncontractile protein occupying the cardiac interstitium. Because myocardial collagen content increases with age, increased myocardial collagen content renders the myocardium less compliant and may be responsible for increased loading of blood vessels.
Age-related pulmonary changes that may affect this patient include: increased tidal volumes weakening of intercostal muscles and the diaphragm improved cough reflex decreased sensation of the glottis
weakening of intercostal muscles and the diaphragm Respiratory muscle function is affected by skeletal muscle and peripheral muscle strength. During aging, skeletal muscle progressively atrophies, and its energy metabolism decreases, which may partially explain the declining strength of the respiratory muscles.
