A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool.

What does this score indicate?

The client is independent in all ADLs.

The client needs assistance with two ADLs.

The client is dependent on others for all ADLs.

The client has difficulty with four ADLs.

Answer and Explanation

The Correct Answer is B

The correct answer is B.

The client needs assistance with two ADLs. This is because the Katz Index of Independence in Activities of Daily Living (ADLs) is a tool that measures the client’s ability to perform six basic ADLs independently: bathing, dressing, toileting, transferring, continence, and feeding. The score ranges from 0 to 6, with 6 indicating complete independence, 4 indicating moderate impairment, and 2 or less indicating severe dependence. The score is based on the number of ADLs that the client can perform without supervision, direction, personal assistance, or total care.

Therefore, a score of 4 out of 6 means that the client needs assistance with two ADLs.

Choice A is wrong because it implies that the client is independent in all ADLs, which would require a score of 6 out of 6.

Choice C is wrong because it implies that the client is dependent on others for all ADLs, which would require a score of 0 out of 6.

Choice D is wrong because it implies that the client has difficulty with four ADLs, which would require a score of 2 out of 6.

The normal range for the Katz Index of Independence in Activities of Daily Living (ADLs) depends on the setting and population of the client. For example, one study found that the average score for residents in skilled nursing facilities was 3.1 out of 6. Another study found that the hierarchy of difficulty of the six ADLs from least to greatest was: eating, maintaining continence, transferring, toileting, dressing, and bathing.

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Correct Answer is ["A","B","C","E"]

Explanation

The correct answer isA, B, C, and E.

The nurse should ask the client about medications, vision problems, home environment, and urinary incontinence as these are all factors that could contribute to falls in older adults.

• Medicationscan increase the risk of falls because they can cause side effects such as drowsiness, dizziness, confusion, or low blood pressure.Some medications that can increase the risk of falls include sedatives, antidepressants, antihypertensives, diuretics, and anticholinergics.

• Vision problemscan impair the ability to see obstacles, judge depth and distance, or adjust to changes in light.Some vision problems that can increase the risk of falls include cataracts, glaucoma, macular degeneration, and diabetic retinopathy.

• Home environmentcan pose safety hazards that can cause tripping, slipping, or losing balance.Some home hazards that can increase the risk of falls include loose rugs, clutter, poor lighting, slippery floors, uneven surfaces, and lack of handrails or grab bars.

• Urinary incontinencecan lead to rushed movements to the bathroom or frequent nighttime trips that can increase the risk of falls.Urinary incontinence can be caused by various factors such as bladder infections, prostate problems, pelvic floor weakness, or medication side effects.

Choice D is wrong because thyroid function is not a direct factor that contributes to falls in older adults.However, thyroid disorders such as hyperthyroidism or hypothyroidism can affect other factors such as muscle strength, bone density, heart rate, or blood pressure that can indirectly increase the risk of falls.

Normal ranges for thyroid function tests vary depending on the laboratory and the method used.However, a common reference range for thyroid-stimulating hormone (TSH) is 0.4 to 4.0 mIU/L and for free thyroxine (FT4) is 0.8 to 1.8 ng/dL.

A. Acetaminophen B. Diphenhydramine C. Metformin D. Lisinopril

Correct Answer is B

Explanation

The correct answer is B.

Diphenhydramine.Diphenhydramine is an antihistamine and sedative medication that can causedeliriumin older adults, especially when used in high doses or for a long time.Delirium is a serious change in mental abilities that results in confused thinking and reduced awareness of the surroundings.It can be caused by various factors, such as infections, medications, surgery, or alcohol or drug use or withdrawal.Delirium can have serious consequences, such as increased risk of falls, complications, and death.

Choice A is wrong because acetaminophen is a pain reliever and fever reducer that does not usually cause delirium in older adults.

However, acetaminophen overdose can cause liver damage and altered mental status.

Choice C is wrong because metformin is an oral medication that lowers blood sugar levels in people with type 2 diabetes.

Metformin does not typically cause delirium in older adults.

However, metformin can cause a rare but serious condition called lactic acidosis, which can cause confusion and other symptoms.

Choice D is wrong because lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure and prevents heart failure.

Lisinopril does not usually cause delirium in older adults.

However, lisinopril can cause a rare but serious condition called angioedema, which can cause swelling of the face, tongue, or throat and difficulty breathing.

Normal ranges for some relevant laboratory tests are:.

• Albumin: 3.5-5.0 g/dL.

• Potassium: 3.5-5.0 mEq/L.

• Total cholesterol: <200 mg/dL.

• Hemoglobin: 13.5-17.5 g/dL for men; 12.0-15.5 g/dL for women.

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A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool. What does this score indicate?

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Correct Answer is ["A","B","C","E"]

Explanation

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Correct Answer is B

Explanation

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A nurse is reviewing the results of a functional status assessment for an older adult client using the Katz Index of Independence in Activities of Daily Living (ADLs). The nurse notes that the client scored 4 out of 6 on this tool.

What does this score indicate?