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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is A.
Adverse drug reactions.
Polypharmacy, which refers to the effects of taking multiple medications concurrently to manage coexisting health problems, is common among older adults.
It is defined as the regular use of at least five medications.
Polypharmacy can lead to an increase in geriatric syndromes, decrease in functional outcomes, and increased mortality.
One of the major risks of polypharmacy is adverse drug reactions, which are harmful or unintended effects of a medication that occur at normal doses.
Adverse drug reactions can result from drug-drug interactions, drug-disease interactions, drug-age interactions, or inappropriate prescribing.
Adverse drug reactions can cause symptoms such as confusion, dizziness, falls, bleeding, or organ damage.
They can also lead to hospitalizations, increased health care costs, and reduced quality of life.
Choice B is wrong because medication adherence, which is the extent to which patients take medications as prescribed by their health care providers, can actually decrease with polypharmacy.
This is because taking multiple medications can be complex, costly, and burdensome for older adults, especially if they have cognitive impairment or low health literacy.
Medication adherence can also be influenced by patients’ beliefs, preferences, and expectations about their medications.
Choice C is wrong because drug-drug interactions are not a risk of polypharmacy per se, but rather a cause of adverse drug reactions.
Drug-drug interactions occur when two or more drugs affect each other’s pharmacokinetics (absorption, distribution, metabolism, excretion) or pharmacodynamics (mechanism of action, efficacy, toxicity).
Drug-drug interactions can alter the therapeutic effects or safety of a medication.
Choice D is wrong because therapeutic effects are the intended or desired effects of a medication that benefit the patient’s health condition.
Therapeutic effects can decrease with polypharmacy due to drug-drug interactions that reduce the efficacy of a medication.
Therapeutic effects can also be diminished by prescribing cascade, which is a phenomenon where a new medication is prescribed to treat a symptom that is actually an adverse drug reaction of another medication.
Normal ranges for blood pressure are.
≤120/80.
mmHg for normal,.
120−129/80.
mmHg for elevated,.
130−139/80−89.
mmHg for stage 1 hypertension, and.
≥140/90.
mmHg for stage 2 hypertension.
Correct Answer is A
Explanation
The correct answer is A.
Decreased metabolic rate.This is because the metabolic rate is the amount of energy that the body uses to maintain its functions, and it tends to decline with age due to various factors, such as loss of muscle mass, reduced activity, hormonal changes, and decreased thyroid function.
A lower metabolic rate means that the body produces less heat and therefore feels colder more easily.
Choice B is wrong because increased blood pressure is not a normal physiological change with aging, but rather a risk factor for cardiovascular diseases that can be influenced by lifestyle, genetics, and other factors.
Choice C is wrong because increased sweat gland activity is not a normal physiological change with aging, but rather a sign of hyperhidrosis, which is a condition that causes excessive sweating due to overactive sweat glands.Sweat glands actually decrease in number and function with age, which can impair thermoregulation and increase the risk of heat-related illnesses.
Choice D is wrong because decreased body fat is not a normal physiological change with aging, but rather a result of malnutrition, illness, or other causes.Body fat actually tends to increase with age, especially in the abdominal region, due to hormonal changes, reduced physical activity, and lower metabolic rate.
Body fat can act as an insulator and help maintain body temperature.
Normal ranges for metabolic rate vary depending on age, sex, body size, activity level, and other factors.
A general estimate for resting metabolic rate (RMR) is 10 calories per kilogram of body weight per day for men and 9 calories per kilogram of body weight per day for women.
However, this may not reflect the actual metabolic rate of an individual, as it does not account for the effects of food intake, exercise, or environmental factors.
Therefore, it is better to measure metabolic rate using indirect calorimetry or other methods that can capture these variables.
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