NU142- Chapter 11: Health Care of the Older Adult
A nurse is caring for a client with dementia. A family member of the client asks what the most common cause of dementia is. Which response by the nurse is most appropriate?
"The most common cause of dementia in the elderly is Alzheimer's disease."
An older adult is experiencing bowel changes. She used to have a bowel movement every day, but she is now having one every 3 to 4 days. She also states that the stools are hard. Which of the following assessments would the nurse make? Select all answers that apply.
Amount of dietary fiber Use of laxatives Activity level of the client Quantity of daily fluid intake
An elderly client with heart failure reports constipation that has progressively worsened over the last several months. The client's vital signs are pulse 86 beats per minute, blood pressure 94/56, and respirations 18 breaths per minute. It would be best for the nurse to instruct the client to
Avoid straining when having a bowel movement.
A nurse is teaching a nutrition class to a group of elderly clients at a retirement center. The nurse tells the clients that as a result of aging, they will need to decrease
Calories
A client with Alzheimer disease becomes agitated while the nurse is attempting to take vital signs. What action by the nurse is most appropriate?
Distract the client with a familiar object or music.
A nurse is preparing to assess an older adult patient. Which approach would the nurse most likely use?
Functional assessment
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 client with Alzheimer's disease is admitted for hip surgery after falling and fracturing the right hip. The client's spouse tells the nurse about feeling guilty for letting the accident happen and reports not sleeping well lately because the spouse has been getting up at night and doing odd things. Which nursing diagnosis is most appropriate for the client's spouse?
Risk for caregiver role strain related to increased client care needs
Which neurotransmitter is implicated in depression?
Serotonin
activities of daily living (ADLs)
personal care activities such as bathing, dressing, grooming, eating, toileting, and transferring
depression
the most common affective (mood) disorder of old age results from changes in reuptake of the neurochemical serotonin in response to chronic illness and emotional stresses
elder abuse
the physical, emotional, or financial harm to an older person by one or more of the individual's children, caregivers, or others includes neglect
polypharmacy
the use of multiple medications
comorbidity
having more than one illness at the same time (e.g., diabetes and congestive heart failure)
A client with Alzheimer's disease is being admitted to the hospital for malnutrition and dehydration. What is the rationale for the nurse to place the client closer to the nurses' station?
limit wandering
A client in a nursing home is diagnosed with Alzheimer's disease and is exhibiting the following symptoms: difficulty with recent and remote memory, apraxia, irritability, depression, restlessness, difficulty swallowing, and occasional incontinence. What stage of Alzheimer's disease should the nurse describe the client?
middle
To encourage adequate nutritional intake for a client with Alzheimer's disease, a nurse should:
stay with the client and encourage him to eat.
An elderly client is hospitalized. To maintain the client's mobility, the best nursing intervention is
Encourage the client to perform active and passive range-of-motion exercises.
The nurse identifies which of the following as an age-related change in the respiratory system?
Increased residual lung volume
Students are preparing a class presentation on elder abuse. Which of the following would they include as the most common type of elder abuse?
Neglect
When assessing an older adult, the nurse anticipates an increase in which component of respiratory status?
Residual lung volume
A family of a patient with Alzheimer's disease asks the nurse what causes this condition? Which response by the nurse would be most appropriate?
"Evidence shows that there are changes in nerve cells and brain chemicals."
An age-related change associated with the cardiovascular system is
decreased cardiac output.
An older adult female client tells the nurse, "I have lost an inch [2.5 cm] of height and have a hump on my back. What can I do about this?" What is the best response by the nurse?
"In order to prevent further bone loss, eat a diet high in calcium and low in phosphorus."
The nurse works on a unit with elderly clients. Which of the following clients would the nurse visit first? The client who reports
"It feels like I have food stuck in my throat."
A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:
"What precipitates the outbursts?"
A hospitalized older adult complains of increased coughing and shortness of breath. The nurse assesses the vital signs as temperature 100.2°F oral, respirations 18, pulse 88, and BP 128/80. What action should the nurse do next?
Assess lung sounds and sputum.
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
A nurse is preparing a presentation for a local senior citizen group about nutrition in the older adult. Which of the following recommendations would the nurse include? Select all that apply.
Daily calcium intake of 1200 mg Carbohydrate intake accounting for 55% of total calories consumed Vitamin D intake of 600 IU per day
Which is an age-related change associated with the cardiovascular system?
Decreased cardiac output
A nurse notes that an older female client has lost 2 inches in height since her appointment last year. The client reports lumbar back pain as unchanged. Which of the following would the nurse instructs the client? Select all answers that apply.
Increase intake of foods that are high in calcium. Take calcium and vitamin D supplements daily. Obtain the prescribed bone density screening.
When performing a respiratory assessment on an older adult patient, what changes associated with aging does the nurse expect to find? (Select all that apply.)
Increased residual volume Loss of elastic tissue surrounding the alveoli Reduced vital capacity
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.
An elderly client is hospitalized for treatment related to leukemia. Family members want to visit with a toddler who has a cold. It would be best for the nurse to
Instruct the family to remove the toddler from the room for the protection of the client.
The nurse is describing hospice services to the family of a patient with end-stage heart failure. Which of the following would the nurse be least likely to include as a major focus of care?
Invasive therapy
An elderly client reports that he feels like he voids frequently during the day and at night but cannot empty his bladder. The nurse instructs the client to
Limit ingestion of caffeinated beverages.
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
A client reports to the nurse that her mother had macular degeneration and is concerned that she, too, may be at risk. What should the nurse tell the client?
Wear sunglasses with ultraviolet (UV) protection when outside.
gerontology
the combined biologic, psychological, and sociologic study of older adults within their environment
presbyopia
the decrease in visual accommodation that occurs with advancing age
presbycusis
the decreased ability to hear high-pitched tones that naturally begins in midlife as a result of irreversible inner ear changes
gerontologic/geriatric nursing
the field of nursing that relates to the assessment, planning, implementation, and evaluation of older adults in all environments, including acute, intermediate, and skilled care, as well as within the community
urinary incontinence
the unplanned loss of urine
orientation
a person's ability to recognize who and where he or she is in a time continuum used to evaluate one's basic cognitive status
An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?
"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."
The nurse is teaching about preventing pneumonia and influenza to a group of clients in a senior citizens' wellness class. The nurse includes which of the following topics in the class? Select all options that apply.
Avoiding environmental smoke Participating in regular exercise Ensuring appropriate fluid intake
Which action by the nurse demonstrates ageism?
Directing all health decisions to the older adult's child
A nurse is teaching nursing assistants in an extended-care facility measures to protect the skin of elderly clients. Which of the following measures is the nurse likely to recommend?
Encouraging clients to avoid cigarette smoking
When assessing an older adult's gastrointestinal system, the nurse would identify an increase in which of the following as normal?
Feeling of fullness
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
A nurse is providing a fall prevention clinic for a group of older adults. What information should the nurse include? Select all that apply.
Place grab bars in the shower and tub Have routine vision and hearing screenings Wear nonslip shoes or socks when walking Review medications routinely for side effects
A client with moderate Alzheimer's disease has been eating poorly, losing weight, and playing with food at meals. The nurse best intervenes by
Placing one food at a time in front of the client during meals
ageism
a bias that discriminates, stigmatizes, and disadvantages older adults based solely on their chronologic age
geriatrics
a field of practice that focuses on the physiology, pathology, diagnosis, and management of the disorders and diseases of older adults
durable power of attorney
a formal, legally endorsed document that identifies a proxy decision maker who can make decisions if the signer becomes incapacitated
delirium
an acute, confused state that begins with disorientation and if not recognized and treated early can progress to changes in level of consciousness, irreversible brain damage, and sometimes death
dementia
broad term for a syndrome characterized by a general decline in higher brain functioning, such as reasoning, with a pattern of eventual decline in the ability to perform even basic activities of daily living, such as toileting and eating
geriatric syndromes
common conditions found in older adults that tend to be multifactorial and do not fall under discrete disease categories these conditions include falls, delirium, frailty, dizziness, and urinary incontinence
instrumental activities of daily living (IADLs)
complex skills needed for independent living, such as shopping, cooking, housework, using the telephone, managing medications and finances, and being able to travel by car or public transportation