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 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.

A. Encourage fluid intake of at least 2 L/day. B. Provide a low-fiber diet. C. Administer a stimulant laxative daily. D. Discourage physical activity.

Correct Answer is A

Explanation

Encourage fluid intake of at least 2 L/day.

This is because adequate hydration can help soften the stool and facilitate its passage through the intestines.Fluid intake should be increased gradually to avoid fluid overload or electrolyte imbalance.

Choice B is wrong because alow-fiber dietcan contribute to constipation by reducing the bulk and water content of the stool.

Fiber helps retain water in the stool and stimulate peristalsis.A high-fiber diet is recommended for clients who have constipation.

Choice C is wrong because astimulant laxativeshould not be used daily or for a long period of time, as it can cause dependence, dehydration, electrolyte imbalance, and damage to the intestinal mucosa.Stimulant laxatives should be used only as a last resort when other measures fail.

Choice D is wrong becausephysical activitycan help prevent constipation by increasing intestinal motility and blood flow.Physical activity should be encouraged for clients who have constipation, unless contraindicated by other conditions.

Normal ranges for fluid intake are about 2 to 3 L/day for adults, depending on age, weight, activity level, and climate.Normal ranges for fiber intake are about 25 to 38 g/day for adults, depending on age and sex.

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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

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Correct Answer is A

Explanation

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Correct Answer is A

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.).