A nurse is implementing interventions to improve the functional status of an older adult client who has diabetes and hypertension.

Which of the following interventions should the nurse include?

(Select all that apply.).

Promote physical activity and exercise to maintain muscle strength, joint mobility, balance and coordination.

Encourage adequate nutrition and hydration to prevent malnutrition, dehydration and electrolyte imbalance.

Manage chronic diseases and medications to prevent complications, adverse effects and polypharmacy.

Provide assistive devices and adaptive equipment to enhance mobility, safety and independence

Modify the environment to reduce hazards, improve accessibility and facilitate self-care.

Answer and Explanation

Correct Answer : A,B,C,E

The correct answer is A, B, C and E. These interventions are consistent with the best practices for optimizing functional status in the elderly.

Some explanations for the choices are:.

• Choice A is correct because physical activity and exercise can help maintain muscle strength, joint mobility, balance and coordination, which are essential for functional independence and quality of life.

• Choice B is correct because adequate nutrition and hydration can prevent malnutrition, dehydration and electrolyte imbalance, which can impair physical and cognitive function and increase the risk of complications.

• Choice C is correct because managing chronic diseases and medications can prevent complications, adverse effects and polypharmacy, which can affect functional status and increase the need for health care services.

• Choice D is wrong because providing assistive devices and adaptive equipment is not an intervention to improve functional status, but rather to enhance mobility, safety and independence for patients who already have functional limitations.

The question asks for interventions to improve functional status, not to compensate for it.

• Choice E is correct because modifying the environment can reduce hazards, improve accessibility and facilitate self-care, which can promote functional independence and prevent injuries or falls.

The normal ranges for blood glucose and blood pressure for older adults with diabetes and hypertension are:.

• Blood glucose: 80-130 mg/dL before meals and less than 180 mg/dL after meals.

• Blood pressure: less than 140/90 mmHg or individualized based on comorbidities and risk factors.

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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

A. “You can try using a vacuum device or a penile implant to achieve an erection.”. B. “You can take oral medications such as sildenafil or tadalafil before sexual activity.”. C. “You can inject medications such as alprostadil or papaverine into your penis before sexual activity.”. D. “You can do any of the above options, depending on your preference and medical condition.”.

Correct Answer is D

Explanation

You can do any of the above options, depending on your preference and medical condition.

Erectile dysfunction (ED) is the inability to get and maintain an erection for sexual activity.

It can be caused by physical or psychological factors, or both.

ED can affect your self-esteem, stress level and relationship quality.

There are different treatment options for ED, and they work in different ways.

Some of the most common ones are:.

• Oral medicationssuch as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Stendra).

These drugs enhance the effects of nitric oxide, a chemical that relaxes the muscles in the penis and increases blood flow.

You need to take them before sexual activity, and they only work if you are sexually stimulated.

They are not safe for everyone, especially if you have heart problems, low blood pressure, liver disease or certain eye conditions.They can also cause side effects such as headache, flushing, nasal congestion or indigestion.

• Penile self-injectionssuch as alprostadil (Caverject, Edex) or papaverine (OraVerse).

These are shots of medicine that you inject into the base or side of your penis with a fine needle.

They cause an erection by dilating the blood vessels in the penis.

The erection lasts about 20 to 30 minutes, and you need to use them only when needed.They can cause side effects such as bleeding, pain, priapism (a prolonged and painful erection) or fibrous tissue formation.

• Alprostadil urethral suppository(Muse).

This is a tiny pellet of medicine that you insert into your urethra (the tube that carries urine out of the body) with a special device.

It works by expanding the blood vessels in the penis and causing an erection.

The erection lasts about 30 to 60 minutes, and you need to use it only when needed.It can cause side effects such as burning, pain, bleeding or infection.

• Vacuum erection device(VED).

This is a plastic tube that you place over your penis and pump out the air to create a vacuum.

This draws blood into the penis and causes an erection.

You then slide a rubber ring around the base of your penis to keep the blood in place.

The erection lasts as long as the ring is on, up to 30 minutes.

You need to use it only when needed.It can cause side effects such as bruising, numbness, pain or difficulty ejaculating.

• Penile implant surgery.

This is a procedure where inflatable or bendable devices are surgically placed on both sides of your penis.

You can control when and how long you have an erection by inflating or deflating the devices with a pump or a switch.This is a permanent solution for ED, but it requires surgery and has risks of infection, mechanical failure or erosion.

Other treatment options for ED include hormone therapy, psychotherapy, lifestyle changes and natural remedies.

However, these may not be as effective or safe as the ones mentioned above.

The best treatment option for you depends on your personal preference, medical condition, cost and availability.

You should talk to your doctor about the benefits and risks of each option and choose the one that suits you best.

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A nurse is implementing interventions to improve the functional status of an older adult client who has diabetes and hypertension. Which of the following interventions should the nurse include? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is evaluating an older adult client who has depression after four weeks of treatment with an antidepressant medication. Which of the following findings would indicate that the medication is effective?

Correct Answer is D

Explanation

A nurse is caring for an older adult client who has erectile dysfunction due to diabetes mellitus. The client asks the nurse what he can do to improve his sexual function. Which of the following responses should the nurse give?

Correct Answer is D

Explanation

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A nurse is implementing interventions to improve the functional status of an older adult client who has diabetes and hypertension.

Which of the following interventions should the nurse include?

(Select all that apply.).