NUR 260 Test 3

On admission to the hospital, an 81-year-old client is recognized to be at risk for polypharmacy. When reviewing the client's medication history, which component would the nurse identify as posing the greatest threat to the client's continence?

The client takes a diuretic for treatment of hypertension and over-the-counter antihistamines during allergy season.

As part of the treatment regimen for the diagnosis of colon cancer, a 73-year-old client has recently received a colostomy. What should the nurse prioritize during discussions in the early stages of patient teaching?

The lifestyle adjustments and effect on self-concept that often accompany colostomies

After a bone density test, an older adult female client tells the nurse, "I don't understand why I have osteoporosis because I eat well and take my calcium." What does the nurse explain as the reason that the client may have osteoporosis?

The loss is from withdrawal of estrogen and a decrease in activity levels.

Which of the following statements most accurately captures an aspect of dental health among older adults?

The presence of dental problems can be indicative of a variety of other diseases.

Callus

Thickened area of skin d/t persistent pressure or friction (can surgically remove or use orthotic devices)

Which of the following is an accumulation of crystalline depositions in articular surfaces, bones, soft tissue, and cartilage?

Tophi

Which of the following conditions can cause a hiatal hernia?

Weakness of the diaphragmic muscle

Which hospitalized older adult will the nurse identify as at highest risk for hip fracture from a fall?

a client with a history of hip fractures from a fall

Objective data when assessing bowel elimination

abdominal shape + bowel sounds

Which medication should the nurse explain as being the most commonly used pain reliever for arthritic pain?

acetaminophen

Corn (Hyperkeratosis)

area of overgrowth of horny layer of epidermis (can be d/t internal or external bone pressure)

rheumatoid arthritis (RA)

arthritis with swelling, stiffness, pain, and degeneration of cartilage in joints caused by chronic soft tissue inflammation; may result in crippling deformities; an autoimmune disease

The client has a history of rheumatoid arthritis and a recurring problem w/pneumonia. Which theory best explains why?

immunity theory

The nurse manager notes a reduction in the number of urinary tract infections being diagnosed in older clients. Which unit-based protocol most likely contributed to this outcome?

inc cranberry juice intake

Which findings best correlate with a diagnosis of osteoarthritis?

inc joint pain

An older adult reports having to get up several times a night to void. Which should the nurse identify as important to teach?

keep night light on in room

Which finding indicates nutritional deficiency in the older adult?

lips appear dry and cracked

Nursing interventions concerning mobility

manage symptoms and conditions that would limit activity

Risk factors for the development of hiatal hernias are those that lead to increased abdominal pressure. Which of the following complications can cause increased abdominal pressure?

obesity

Teaching plan for colon resection related to colorectal cancer?

ostomy care

Osteoarthritis (OA)

progressive deterioration + abrasion of joint cartilage, with the formation of new bone at the joint surfaces

An older client reports having xerostomia. What should the nurse suggest to this client?

sip water

RN concerned that a client is at risk for developing osteoporosis. What finding caused the nurse to have this concern?

smokes cigs

Management of corn (Hyperkeratosis)

soak, scrape, protect, surgery, injections

Fecal Impaction

stool stuck in rectum or lower bowel d/t chronic constipation

RN working w/older adult female client w/osteoporosis. Which interaction promotes achievement of wellness outcomes?

teaching about bone density in older women and the role of vitamin D + calcium

True of false: If an impaction is not relieved, obstruction or perforation of the bowel wall can occur.

true

RN suggests client with fractured hip should increase intake of which of following to facilitate calcium absorption?

vitamin D

When obtaining a nursing history on a client with a suspected gastric ulcer, which signs and symptoms would the nurse expect to see? Select all that apply.

vomiting + weight loss

Bone fractures are a serious risk to the elderly. Which of the following is a contributing factor?

Dec calcium

The client is a healthy, active 85-year-old with constipation. Which of the following age-related changes may contribute to this complaint?

Decreased sensory perception

The nurse discusses nutritional health with an 89-year-old client whose total protein level is 5 (abnormally low). Which of the following physiological changes should the nurse interpret as a potential pathological process rather than a normal age-related change?

Decreased teeth and chewing ability

The nurse assesses a client with abdominal and rectal discomfort, diarrhea, and fever. What initial data source should the nurse use to determine a possible cause of his symptoms?

Defecation record, for frequency and character of bowel movements

The history of a 70-year-old female indicates that she has been taking laxatives daily for years. Which of her following complaints may be a result of this laxative abuse?

Dehydration

Older adult client is admitted to nursing home. What aspect of health status is most likely to pose risk to nutrition?

Dementia

The most common affective or mood disorder of old age is

Depression

musculoskeletal disorders can result in

Discomfort, disability, deformity, + functional impairment

An older adult client with osteoarthritis walked 2 miles last week. The client says since that time, "I haven't been doing very much; I'm afraid it will hurt like last time." Which action by the nurse is most appropriate?

Discuss moderation in activity, encouraging continued movement.

A client with a peptic ulcer reports epigastric pain that frequently awakens her at night, a feeling of fullness in the abdomen, and a feeling of anxiety about her health. Based on this information, which nursing diagnosis would be most appropriate?

Disturbed Sleep Pattern related to epigastric pain

Mr. J, age 81, has been admitted to hospital for the treatment of diverticulitis. It is noted in his history that Mr. J has a history of depression. Which of the following nursing actions is most likely to foster his mental health?

Encouraging Mr. J to make decisions regarding his routine and care.

Decreased renal mass and reduced glomerular filtration make it especially important that nurses:

Ensure that age-adjusted drug dosages are prescribed

Which of the following symptoms is common with a hiatal hernia?

Esophageal reflux

Which of the following tests can be used to diagnose ulcers?

Esophagogastroduodenoscopy (EGD)

The nurse discusses gallbladder disease with a client diagnosed with cholelithiasis. The client indicates understanding of the pathological process when the client states:

"I will be undergoing laparoscopic surgery to remove the stones."

A nurse is teaching a client with osteoporosis about dietary selections. What client statement indicates the teaching was effective?

"I will eat more dairy products to increase my calcium intake."

A nurse is teaching health interventions to an older adult with osteoarthritis. Which of these statements indicates that the individual needs additional teaching?

"I will try to limit my use of walkers and assistive devices."

Pt w/rheumatoid arthritis in remission without s/s. Tells RN they don't need meds anymore. Best RN response?

"Important to continue to take meds to avoid an acute exacerbation"

A client is taking an antacid for treatment of a peptic ulcer. Which of the following statements best indicates that the client understands how to correctly take the antacid?

"It is best for me to take my antacid 1 to 3 hours after meals."

The nurse teaches a group of older adults about diet. Which of following recommendations made by the nurse is most likely to result in the promotion of gastrointestinal (GI) health?

"It's important to emphasize fiber and fluid intake."

A 76-year-old client has been diagnosed with an axial hiatal hernia following several months of belching and heartburn. What should the nurse teach the client about the management of this health problem?

"Losing weight and trying a bland diet might help alleviate some of the symptoms you're experiencing."

A client asks the nurse what the difference is between osteoarthritis (OA) and rheumatoid arthritis (RA). Which response is correct?

"OA is a noninflammatory joint disease. RA is characterized by inflamed, swollen joints."

A 75-year-old client tells the nurse, "When I feel the need to urinate, I cannot hold it until I get to the toilet." Which suggestion would be appropriate?

"Remind yourself to urinate every two hours during the day." = want toileting schedule

The nurse provides medication instructions to a client with peptic ulcer disease. Which statement, if made by the client, indicates the best understanding of the medication therapy?

"The cimetidine (Tagamet) will cause me to produce less stomach acid."

Pt w/rheumatoid arthritis asks RN what to do to help ease s/s of the disease. Best response by RN?

"The health care provider could prescribe anti-inflammatory drugs."

A nurse conducts a class for family members who are providing care to older adult relatives. An attendee asks, "My mother has had frequent urinary tract infections. What can I do?" Which suggestion would be most appropriate?

"Try making changes to your mother's diet to include eggs, cheese, and fish."

At a health promotion class at a senior's center, a 67-year-old client asks the nurse, "What can be done to help manage my spouse's diverticular disease?" What is the nurse's most appropriate response to this client's query?

"Try to increase the amount of fiber that you include in the meals you cook."

The nurse in the emergency department assesses a 76-year-old female client. The client's bladder is visibly distended and the client has not voided since the previous evening. Which assessment question would be most important to determine the source of the client's condition?

"When was your last bowel movement?" (fecal impaction causes incontinence)

Priority teaching for older adult with gout?

"You should avoid alcohol, as well as many kinds of meat and seafood."

The nurse educates an older adult client with stress incontinence. Which statement will the nurse include in the education?

"Your condition is a result of increased pressure in the abdomen."

Older adult with hip fracture expresses disappointment at not being able to drive to church. Best holistic RN response?

"Your spirituality sounds important to you."

Son of an older client asks why a urinary catheter is not being used to control their dad's incontinence. What should RN respond?

"a catheter is the last resort to control incotinence"

Which nursing diagnoses is/are most applicable to a client with fecal incontinence? Select all that apply.

- Bowel Incontinence - Disturbed Body Image - Social Isolation - Risk for Impaired Skin Integrity

Which of the following would be symptoms of depression in an elderly person?

- Inattention to hygiene - Changes in sleep patterns - Physical complaints such as anorexia, constipation, headache, and indigestion

You're providing a community in-service about gastrointestinal disorders. During your teaching about cholecystitis, you discuss how cholelithiasis can lead to this condition. What are the risk factors for cholelithiasis that you will include in your teaching to the participants? Select all that apply:*

- Inc age - Women - Native American - Fam history - Obesity - Pregnant

The nurse reviews the care that a client with delirium needs. Which intervention should the nurse remind nursing assistive personnel to implement? Select all that apply.

- Orient to reality - Gently touch the client - Use soothing communication - Engage in a diversional activity

Your recent admission has acute cholecystitis. The patient is awaiting a cholecystostomy. What signs and symptoms are associated with this condition? Select all that apply:

1. Epigastric pain that radiates to the right scapula 2. Pain and fullness that increases after a greasy or spicy meal 3. Fever 4. Tachycardia 5. Nausea

The nurse is caring for a patient who has been diagnosed with "rheumatic disease." What nursing diagnoses will most likely apply to this patient's care?

1. Fatigue 2. Pain 3. Alteration in self-concept

Nursing interventions for age-related changes affecting a person's ability to exercise.

1. Monitor heart rate, hydration, fatigue we do this by taking daily weights + progress vs injury 2. Elderly persons have a longer recovery time (make sure to rest + allow body to recover) 3. Always maintain safety treating pain (pain inhibits activity + can lead to depression)

A gerontological nurse is providing care to several older adult clients. On which client's plan of care would the nurse most likely include teaching of Kegel exercises?

A 67-year-old female client living with stress incontinence since having her children

Which of the following older adults is likely at the highest risk for developing esophageal cancer?

A 74-year-old with alcoholism who has chewed tobacco for many decades.

Which of the following diagnostic and assessment findings from among the patients on a geriatric medical unit most warrants further investigation?

A 78-year-old man has recently developed urinary incontinence.

Which of the following definitions best describes diverticulosis?

A non-inflamed out pouching of the intestine

A client who is blind comes to the clinic for a routine check-up. The nurse notes the client is exhibiting signs and symptoms of depression. What nursing action is recommended when helping a blind client who is depressed?

Acknowledge the client's grief.

The nurse teaches a 65-year-old client with a chronic constipation problem. In reviewing her dietary habits, the nurse finds that the client's diet is low in fiber. Which of the following points should the nurse prioritize when teaching about increasing fiber intake?

Add fiber gradually to minimize symptoms of gas or bloating.

A nurse is managing care of a client w/ osteoarthritis. What is appropriate treatment strategy the nurse will teach?

Administer NSAIDs (nonsteroidal anti-inflam)

A nurse is teaching a client about the risk factors associated with colorectal cancer the nurse determines that further teaching related to colorectal cancer is necessary if the client identifies which of the following as an associated risk factor?

Age younger than 50

Which nursing diagnosis is most likely to apply to an older adult client who has prostate enlargement?

Impaired urinary elimination

The nurse teaches an 87-year-old inactive client about avoiding constipation. Which of the following fluid and diet choices should the nurse include in the teaching?

Increase intake of fruit juices

Plantar Fasciitis

Inflammation of the foot-supporting fascia (acute onset of heel pain)

The nurse prepares to give a presentation on the pathology of caries to a group of seniors. Which of the following rationales is correct when understanding why today's elders had a greater risk of caries when they were young than today's children and young adults?

Lack of fluoride in the water

A nurse is assisting with the education of a family of a client with dementia. Which response by the nurse would be the most accurate definition of dementia?

Loss of intellectual abilities that impairs the ability to perform basic care

Which of the following types of diets is implicated in the development of diverticulosis?

Low-fiber diet

A client is in Buck's traction after fracturing his right hip. The nurse should include which action in the care plan?

Maintaining correct body alignment

An 81-year-old client has developed a fecal impaction while convalescing at home after hip surgery. Which of the following corrective actions should the nurse undertake?

Manually remove the feces with a gloved finger. (can use enema or internal massage too)

Flatulence in older adult

Can be from constipation, high fiber foods, irregular bowel movements, age r/t changes to sphincter function *very common*

During a physical exam, the nurse notes that the patient has a smooth red tongue. Which of the following diagnostic tests is an expected follow-up?

Complete a nutrition screening.

A nurse is providing care to a 75-year-old client who is experiencing urinary incontinence. Assessment reveals that the client is not fully emptying the bladder with each voiding, which contributes to urinary incontinence. Which intervention would the nurse implement to promote the client's ability to empty the bladder?

Massaging the bladder area with each voiding

When caring for a client diagnosed with Alzheimer's disease, which nursing intervention is a priority?

Monitor the client carefully

A patient comes to the health center reporting headache, backache, and abdominal pain. Further assessment leads the nurse to suspect that the patient has depression based on an understanding of which of the following?

Most patients experiencing depression seek treatment for somatic problems.

Which one of the following residents of a long-term care facility is most likely exhibiting signs and symptoms of depression?

Mrs. L, age 79, who has withdrawn from her regular bridge games and no longer returns calls to her friends.

Which of the following are usually the first choice in the treatment of rheumatoid arthritis (RA)?

NSAIDs

The nurse plans the care of the older adult with dysphagia. Which of the following is the priority initial nursing intervention?

Observe the patient's food intake

A family member is caring for an older adult client with osteoporosis in the home. When the home health nurse comes to evaluate the client, what should be a focus point of the visit?

Observing for safety hazards that could be a fall risk

A nurse should advise a patient with gout to avoid which of the following foods?

Organ meats and scallops

A client with heel pain is diagnosed with plantar fasciitis. What treatment should the nurse expect to be prescribed for this client?

Orthotics

The nurse discusses dental health with an aging client. Which of the following physiological changes should the nurse interpret as a potential pathological process rather than a normal age-related change?

Periodontal disease causing tooth loss

The nurse is caring for a confused older adult client who experiences urinary frequency and urgency. Which priority safety action should the nurse take?

Place client on fall risk precautions

The nurse teaches the client who recently had hiatal hernia diagnosed. To keep the patient free from pain, what should the nurse recommend?

Remain upright for 1 hour after eating

The nurse identifies the diagnosis of Impaired Urinary Elimination for an older client. What identifying factor did the nurse use when selecting this nursing diagnosis?

Retention

During hip fracture post-op care for older adult, RN should implement which principle about pain management?

Risks of adverse effects of analgesics are higher in older adults.

Which neurotransmitter is implicated in depression?

Serotonin

After complaining about severe depression following the death of a daughter, a 77-year-old client is prescribed an antidepressant. Recently, the client was diagnosed with an oral fungal infection. What should the nurse suggest to the client?

Sip water to promote saliva

A 70-year-old patient with lung cancer is receiving transdermal doses of a narcotic analgesic. Which of the following nursing interventions can minimize any gastrointestinal (GI) issues?

Start the patient on a bowel regimen

In teaching clients with osteoarthritis about their condition, it would be important for the nurse to focus on:

Strategies for remaining active - want to implement PT + exercise (also manage pain)

The older client has risk of injury related to urinary incontinence. Which goal is the most important to facilitate physiologic balance?

The client is free from falls r/t escaped urine.

The older adult patient with a catheter asks the RN "How long will I need to have this catheter?" How will the nurse respond?

"I will assess daily to determine whether the catheter is still needed"

RN assessing GU status of older adult female patient experiencing stress incontinence. What finding is a common gerontologic finding?

"bladder capacity decreases w/ advances age"

RN completes discharge teaching for older adult client with renal calculi. The nurse would emphasize which?

"fluid intake of at least 2 L each day"

Pt reports GI upset since starting allopurinol to treat gout. Which will RN give to prevent these symptoms?

"keep record of each dose, note when s/s begin, contact provider"

A nurse is assessing a 71-year-old client's urinary function. Which finding would the nurse identify as a cause for concern?

"the pH of urine sample is 9.0"

Depression in older adults s/s

** Cognitive + physical s/s** exhausted, aches, pains, hard to remember/concentrate/focus (can include withdrawal, helpless, useless, losing interest, weight loss)

The nurse develops a plan of care for a 75-year-old male patient who has had a myocardial infarction (MI). Which of following characteristics of the man's history and present conditions predispose him to constipation? (Select all that apply.)

- The man's activity level is significantly reduced as a result of his MI. - The man has received several doses of morphine since admission. - The man's fluid intake has been minimal since admission.

The environment of a client with dementia includes photographs of the client's family, soft music and low lighting. The client wears personal items received as gifts. Unused electrical outlets are covered. Once a day, the client exercises with a group. Which item would the nurse identify as missing from this picture?

ID bracelet

The client with a fractured femur is upset and agitated that skeletal traction will be necessary for 6 to 8 weeks. The client states, "How can I stay like this for weeks? I can't even move!" Based on these statements, the nurse would identify which of the following as the most appropriate nursing diagnosis?

Ineffective Coping related to prolonged immobility

Dementia

Irreversible, progressive impairment in cognitive function **Pt w/ dementia can experience delirium**

RN works on a unit with elderly clients. Which of following clients would RN visit first? The client who reports

It feels like I have food stuck in my throat

Dysphagia

Swallowing difficulties w/ inc age (can be d/t GERD, stroke or functional disorders of mouth/throat)

What assessment finding indicates a possible UTI in the older adult?

new onset of delirium

most significant risk factor for falls in elderly community is ______

nocturia (Renal circulation when lying down = inc fluid excretion + output)

Oropharyngeal Dysphagia

problem transferring food from mouth to pharynx/esophagus (d/t neurological deficit)

Pt on SQ heparin after surgery to repair fracture hip. Rationale for this therapy is to reduce risk for?

pulmonary embolism

Which finding indicates pathology rather than normal age-related changes?

red and swollen gums

Pt with weak gag reflex, which RN diagnosis is priority?

risk of aspiration

A client is recovering from a fractured hip. The nurse would suggest that the client increase intake of which of the following to facilitate calcium absorption from food and supplements?

vitamin d

Fecal impaction nursing interventions (to prevent + manage)

• A bowel elimination record • inc fluids + fiber • Enema • No laxative overuse • Use bathroom when body tells

Delirium

• Acute confusion, usually reversible • Disorientation of time + place, altered attention span, worsened memory, poor judgement, personality changes

Urinary System Health Promotion

• Adequate fluid intake, • Inc vitamin C intake (help dec acidic urine) • Activity • Frequent toileting (sit upright, massage bladder, rock back-and-forth, run water)

Age related changes (depression)

• Dec cerebral blood flow • Changes in neuroendocrine system • Disruptions in circadian rhythm

Fecal impaction s/s =

• Distended rectum • Abdominal/rectal discomfort • Oozing stool around impaction (mistaken for diarrhea) • Palpable hard mass • Fever

Muscle age related changes

• Increase in collagen and resultant fibrosis • Muscles diminish in size = atrophy • Muscle wasting • Tendons less elastic = weak + fatigue

Ligaments age related changes

• Lax ligaments = less than normal strength • Weakness • Joint pain w/ motion, swelling, crepitus + osteoarthritis

How to make sure elderly pt w/ nocturia is safe when toileting

• Night light • lear path • No throw rugs or clutter • Dec fluids before bed

Hammer toe management

• Open-toed shoes • Manipulative exercises • Pads • Surgery

Joint age related changes

• Progressive deterioration of cartilage • Thinning of intervertebral discs • Stiff, dec flexibility + pain (all interfere w/ ADLs)

Hallux Valgus (bunion) management

• Shoe fitting (want to prevent pressure) • Fam history • Corticosteroids • Surgery

Risk factors for depression or suicide

• Social isolation • Childhood trauma • Family history • Trauma (stroke, cancer, parkinson's etc.) • Disability/limitations

Plantar Fasciitis management

• Stretching • Shoe support • Orthotic devices • Corticosteroids

Causes of Flatulence

• Swallowing air • End result of digestion in large intestine (can hurt if inability to expel)

A dentist examines an 80-year-old man with a history of pipe smoking. The dentist notes white patches in the patient's mouth. What action should be the dentist's priority?

Biopsy the lesion

A guaiac test has been ordered. The nurse knows that this is a test for

Blood that cannot be seen.

A 74-year-old woman has presented to the emergency department with a suspected hip fracture following a fall on the sidewalk outside her home. The nurse's assessment of the client would recognize which of the following factors as most likely contributed to the suspected injury?

Bone minerals and mass are reduced as part of the aging process.

The nurse teaches the patient that the presence of crystals in his or her synovial fluid confirms which disease process?

gout

Pt w/recent fatigue, nausea, vomiting, fever, and urinalysis with proteinuria and hematuria. RN suspects?

glomerulonephritis

Client complains of pain in right great toe which is worse at night. Assessment reveals tophi. What does RN suspect?

gouty arthritis

Which assessment finding indicates the client w/osteoarthritis is having difficulty implementing self-care?

has a weight gain of 5 pounds

A daughter complains that her mother, who has Alzheimer's disease, thinks and acts so slowly that everything must be done for her. Which suggestion would be most appropriate for the nurse to provide initially to the daughter that might be helpful for both the client and herself?

"Encourage you mother's self-care, but do it under supervision"

The nurse discusses dental health with an 81-year-old client. Which of the following statements, when made by the client is identified as true?

"Fluoride treatments might help strengthen the enamel on my teeth."

RN provides diet teaching to older adult client w/gout. Which statement indicates additional instruction required?

"I can eat bacon with my eggs for breakfast."

The nurse reviews an older adult client's urinary symptoms. Which statement by the client requires further follow up by the nurse?

"I have trouble making it to the restroom on time."

Which of the following statements by older adult clients should the nurse interpret as a potential pathological process rather than a normal age-related change?

"I tend to regurgitate a lot of my food after a meal these days."

A client who has suffered a compound fracture is preparing for discharge to home. During the teaching session, the client asks why he needs antibiotics for a broken bone. Which response by the nurse is most appropriate?

"Antibiotic therapy has been prescribed as a precaution because your bone was exposed to the environment at the time of your injury."

Which of the following tests can be performed to diagnose a hiatal hernia?

Barium swallow

As a person ages, muscle tone decreases throughout the digestive system, causing a slowing movement of food through the esophagus. Delayed esophageal emptying in the elderly increases the risk of:

Aspiration

An 84-year-old man who resides in a long-term care facility has recently become incontinent of bowel, a situation that is without precedent. What is the nurse's priority for assessment?

Assessment for the presence of fecal impaction

A 77-year-old post-surgical patient has been complaining of abdominal pain throughout the nurse's shift. In addition, the patient has a temperature of 101.5°F (38.5°C) and has had small, frequent, loose bowel movements four times since the morning. Which of the following health problems would the nurse suspect?

Fecal impaction (oozing is commonly mistaken for diarrhea)

Hammer toe

Flexion deformity (can involve several toes) that can be d/t tight socks + shoes pushing toes upward and back

Which of the following is the most common urinary problem among men aged 65 years and older?

Frequent urination

The nurse assists the aging client to create a menu. Which of the following foods, if requested by the client will require further teaching as it should not be included on this list?

Fried chicken

The nurse in the office advises a client with ongoing issues with constipation to keep a food journal. During a typical 24-hour period, the client has a bagel and coffee for breakfast, macaroni and cheese for lunch, and soup and salad for supper. What dietary changes should the nurse recommend to this client?

Gradually increase the amount of fiber in the daily diet

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

Has a weight gain of 5 pounds + reports inc fatigue

The nurse is evaluating and assessing an older adult with a new-onset of bowel obstruction. When assessing the client, what should the nurse observe for?

High-pitched bowel sounds

RN emphasizes measures to reduce risk of falls based on understanding that which fracture is most common in older adults

Hip

Osteoporosis

bone condition characterized by low bone density and porous bones

Dry Mouth (xerostomia)

dec saliva prod d/t aging (can be d/t meds, mouth breathing, diuretics, cognitive defects)

Differentiation between delirium and dementia

dementia is irreversible

Esophageal Dysphagia

difficulty propelling food down esophagus (d/t motiity disorders, mechanical obstruction or inefficient sphincter)

xerostomia is also known as

dry mouth

Instructions for patient with dysphagia?

eat in upright position to improve swallowing

True or false: Choosing an exercise program for an older adult can be achieved by identifying common activities that older adults enjoy and implementing a program based on your findings from the literature.

false (based on persons capacity + limitations)

Which instruction is appropriate for a patient with renal calculi?

fluid intake of at least 2 liters per day

Onychocryptosis (ingrown toenails)

free edge of nail plate penetrates surrounding skin (can develop secondary infection or granulation) PAINFUL

What subjective data should you collect from the patient for the assessment parameters for bowel elimination.

frequency, color, amount, consistency, unusual shape, unusual odor.

Hallux Valgus (bunion) risk factors

• Heredity • Shoes • OA • Aging

Onychocryptosis (ingrown toenails) risk factors

• Improper self-treatment • External pressure (tight shoes/socks) • Internal pressure (deformed toes) • Trauma • Infection

Sarcopenia age related changes

• Poor blood flow to muscles • Dysfunction at cellular level • Dec hormones • Inc pro-inflam cytokines

Onychocryptosis (ingrown toenails) prevention + management

• foot care (wash daily) • trim nails straight across + file edges • Dec pressure around foot • Surgical removal

Bone age related changes

•Gradual, progressive loss of bone mass after 30 years of age (Kyphosis, loss of flexibility, back pain, osteoporosis) •Vertebral collapse

A client is complaining of severe pain in the left great toe. What lab studies that the nurse reviews indicate that the client may have gout?

Elevated uric acid levels

Sarcopenia

Age-related reduction of muscle mass/function d/t dec protein synthesis + inc muscle protein degeneration **can lead to disability/immobility, disease**

A nurse is providing care to an older adult client with dementia. Which intervention would the nurse identify as a priority?

Ensuring client safety

The nurse is assessing a 73-year-old client who was diagnosed with metastatic prostate cancer. The nurse notes that the client is exhibiting signs of loss, grief, and intense sadness. Based on this assessment

Depression

Hallux Valgus (bunion)

Deformity where great toe deviates laterally (2nd to pressure + inflammation)