A nurse is caring for an older adult client who has depression and reports having chronic pain in his lower back.

Which of the following actions should the nurse take?

Assess the location, intensity, quality and duration of the pain using a pain scale

Administer analgesic medications as prescribed and monitor for effectiveness and side effects.

Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction.

All of the above.

Answer and Explanation

The Correct Answer is D

The correct answer is D.

All of the above.

The nurse should take all of the actions listed to provide effective pain management for the older adult client who has depression and chronic pain in his lower back.

• Choice A is correct because assessing the pain using a valid and reliable pain scale is essential for determining the severity and impact of pain, as well as monitoring the response to treatment.

• Choice B is correct because administering analgesic medications as prescribed can help reduce pain and improve function.

The nurse should also monitor for effectiveness and side effects, especially in older adults who may have altered drug metabolism, polypharmacy, and increased risk of adverse events.

• Choice C is correct because providing non-pharmacological interventions can enhance pain relief, reduce medication use, and address the biopsychosocial aspects of pain.

Massage, heat or cold therapy, relaxation techniques, and distraction are some examples of non-pharmacological interventions that can be used for chronic pain in older adults.

• Choice D is correct because it includes all of the above actions, which are part of a multimodal approach to pain management that is recommended by clinical guidelines.

4 7 A multimodal approach can improve pain outcomes, reduce side effects, and address the complex needs of older adults with chronic pain.

A. Assess the location, intensity, quality and duration of the pain using a pain scale B.

Administer analgesic medications as prescribed and monitor for effectiveness and side effects C.

Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction D.

All of the above

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Correct Answer is A

Explanation

The correct answer is A.“Do you drive your own car or use public transportation?.” This question is appropriate for the domain ofmode of transportation, which is one of the eight areas of occupational performance assessed by the Lawton Instrumental Activities of Daily Living (IADLs) Scale.The scale evaluates a person’s ability to engage in more complex activities thought necessary for functioning in community settings.

Choice B is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofability to use a telephone.The scale asks about the person’s ability to operate a telephone, dial numbers, and answer calls.

Choice C is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofshopping.The scale asks about the person’s ability to take care of all shopping needs independently, shop for small purchases, or need assistance with shopping.

Choice D is wrong because it is not related to the domain of mode of transportation, but rather to the domain ofmobility.The scale does not assess mobility directly, but it may be inferred from the person’s ability to travel by public transportation or car.

The Lawton IADLs Scale has a summary score that ranges from 0 (low function, dependent) to 8 (high function, independent) for women, and 0 to 5 for men.The score identifies areas of need in regard to care and support.

A. The client reports an improvement in mood, energy, appetite and sleep. B. The client scores lower on the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire (PHQ-9). C. The client shows more interest and participation in social activities and hobbies. D. All of the above.

Correct Answer is D

Explanation

The correct answer is D.

All of the above.

This is because all of these findings indicate that the client has experienced an improvement in mood, energy, appetite, sleep, interest and participation in social activities and hobbies, which are common signs of depression recovery.

Choice A is wrong because it only covers some of the symptoms of depression, such as mood, energy, appetite and sleep, but not others, such as interest and participation in social activities and hobbies.

Choice B is wrong because it only measures the client’s depression level using standardized scales, such as the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire (PHQ-9), but not their actual functioning and quality of life.

Choice C is wrong because it only reflects the client’s interest and participation in social activities and hobbies, which are important aspects of depression recovery, but not their mood, energy, appetite, sleep or depression level.

The GDS and the PHQ-9 are both valid and reliable tools for screening and measuring depression in older adults.

The GDS is a 15-item questionnaire that asks the client to answer yes or no to questions about their mood, satisfaction, hopelessness, helplessness, worthlessness, guilt, agitation, withdrawal and suicidal thoughts.

The PHQ-9 is a 9-item questionnaire that asks the client to rate how often they have experienced symptoms of depression in the past two weeks, such as depressed mood, anhedonia, insomnia or hypersomnia, fatigue, appetite or weight changes, concentration problems, feelings of worthlessness or guilt.

A. The client reports an improvement in mood, energy, appetite and sleep B.

The client scores lower on the Geriatric Depression Scale (GDS) or the Patient Health Questionnaire (PHQ-9) C.

The client shows more interest and participation in social activities and hobbies D.

All of the above

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A nurse is caring for an older adult client who has depression and reports having chronic pain in his lower back. Which of the following actions should the nurse take?

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A nurse is caring for an older adult client who has depression and reports having chronic pain in his lower back.

Which of the following actions should the nurse take?