Which condition is included in the diagnosis of chronic obstructive pulmonary disease (COPD)?

Choice A reason: This is the correct answer because baroreceptor function diminishes with age, and this can affect the regulation of blood pressure and heart rate. Baroreceptors are sensory receptors that detect changes in blood pressure and send signals to the brain to adjust the heart rate and blood vessel tone accordingly. When a person exercises, the blood pressure and heart rate increase to meet the increased oxygen demand of the muscles. When a person stops exercising, the blood pressure and heart rate should decrease gradually to return to the resting state. However, if a person does not cool down properly after exercising, the blood pressure and heart rate can drop suddenly, causing dizziness, fainting, or cardiac arrhythmias. This is especially true for older adults, whose baroreceptors are less sensitive and responsive to blood pressure changes. Therefore, the nurse should instruct the older man to cool down after exercising to prevent these complications.

Choice B reason: This is incorrect because sensory perception diminishes with age, but this is not related to the importance of cooling down after exercising. Sensory perception is the ability to perceive stimuli from the environment, such as sight, hearing, touch, smell, or taste. Sensory perception can decline with age due to various factors, such as age-related changes in the sensory organs, nerve damage, or diseases. This can affect the quality of life, communication, and safety of older adults, but it does not explain why cooling down after exercising is important.

Choice C reason: This is incorrect because cardiac output diminishes with age, but this is not related to the importance of cooling down after exercising. Cardiac output is the amount of blood pumped by the heart per minute, and it depends on the heart rate and the stroke volume. Cardiac output can decline with age due to various factors, such as age-related changes in the heart muscle, valves, or arteries, or diseases. This can affect the ability of the heart to meet the oxygen demand of the body, especially during exercise, but it does not explain why cooling down after exercising is important.

Choice D reason: This is incorrect because mobility capacity decreases with age, but this is not related to the importance of cooling down after exercising. Mobility capacity is the ability to move and perform physical activities, such as walking, climbing stairs, or lifting objects. Mobility capacity can decrease with age due to various factors, such as age-related changes in the muscles, bones, or joints, or diseases. This can affect the functional status, independence, and well-being of older adults, but it does not explain why cooling down after exercising is important.

Choice A reason: Determining coughing frequency is not a reliable way to assess whether the client has adhered to prescribed therapy, as coughing can have various causes and may not be related to heart failure or its treatment.

Choice B reason: Checking for peripheral edema is a useful way to assess whether the client has adhered to prescribed therapy, as peripheral edema is a common sign of fluid retention and worsening heart failure. If the client has been taking diuretics as prescribed, the edema should be reduced or absent.

Choice C reason: Auscultating the lungs bilaterally is a helpful way to assess whether the client has adhered to prescribed therapy, as lung sounds can indicate the presence or absence of pulmonary congestion and crackles, which are signs of fluid overload and worsening heart failure. If the client has been taking medications to improve cardiac function and reduce fluid volume as prescribed, the lungs should be clear or improved.

Choice D reason: Assessing diet over the last 48 hours is a relevant way to assess whether the client has adhered to prescribed therapy, as diet can affect fluid and sodium intake and retention, which can worsen heart failure. If the client has been following a low-sodium and fluid-restricted diet as prescribed, the risk of fluid overload and dyspnea should be lower.

Choice E reason: Comparing current weight to baseline is an important way to assess whether the client has adhered to prescribed therapy, as weight can reflect fluid status and changes in heart failure condition. If the client has been taking medications and following dietary recommendations as prescribed, the weight should be stable or decreased.