The nurse is assessing an older adult client who has osteoporosis and reports frequent falls.

The nurse should ask the client about which of the following factors that could contribute to falls?

(Select all that apply.).

Medications

Vision problems

Home environment.

Thyroid function.

Urinary incontinence.

Answer and Explanation

Correct Answer : A,B,C,E

The correct answer is A, 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.

• Medications can 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 problems can 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 environment can 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 incontinence can 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.

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

Explanation

The correct answer is A, B and C.

These are the factors that increase the risk of respiratory infections in elderly patients:.

• Decreased immune response: Elderly patients have a weaker immune system that makes them more susceptible to viral and bacterial infections.They also have a poor response to respiratory vaccines.

• Decreased chest wall compliance: Elderly patients have reduced elasticity of the lungs and chest wall, which makes it harder for them to breathe and expel mucus.

• Decreased alveolar surface area: Elderly patients have fewer and larger alveoli, which reduces the gas exchange area and oxygen diffusion capacity.

Choice D is wrong because decreased oxygen saturation is not a risk factor, but a consequence of respiratory infections.

Choice E is wrong because decreased bronchial dilation is not a specific factor for elderly patients, but a common feature of obstructive lung diseases.

Normal ranges for oxygen saturation are 95-100% and for bronchial dilation are variable depending on the type and severity of the disease.

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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The nurse is assessing an older adult client who has osteoporosis and reports frequent falls. The nurse should ask the client about which of the following factors that could contribute to falls? (Select all that apply.).

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Explanation

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The nurse is assessing an older adult client who has osteoporosis and reports frequent falls.

The nurse should ask the client about which of the following factors that could contribute to falls?

(Select all that apply.).