Which of the following is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of heart failure (HF) in older adults?
Control fluid balance.
Control blood pressure.
Prevent deconditioning.
Maintain client safety.
The Correct Answer is A
Choice A reason: Controlling fluid balance is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as fluid overload is the main cause of HF worsening and hospital admission. Fluid balance can be controlled by monitoring weight, intake and output, edema, and lung sounds, and by administering diuretics, restricting sodium and fluid intake, and elevating the legs.
Choice B reason: Controlling blood pressure is an important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as hypertension is a risk factor and a complication of HF. However, it is not the most important goal, as blood pressure may not always reflect the fluid status or the severity of HF. Blood pressure can be controlled by administering antihypertensive medications, such as angiotensin-converting enzyme inhibitors, beta-blockers, or calcium channel blockers, and by encouraging lifestyle modifications, such as smoking cessation, weight management, and stress reduction.
Choice C reason: Preventing deconditioning is an important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as deconditioning is a common problem in HF patients due to reduced physical activity, fatigue, and muscle wasting. However, it is not the most important goal, as deconditioning may not directly affect the fluid balance or the cardiac function. Deconditioning can be prevented by providing exercise training, such as aerobic, resistance, or interval training, and by promoting self-care and adherence to the treatment regimen.
Choice D reason: Maintaining client safety is an important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as HF patients are at risk of falls, injuries, infections, or adverse drug reactions. However, it is not the most important goal, as client safety may not specifically address the fluid balance or the cardiac function. Client safety can be maintained by providing a safe environment, such as removing clutter, providing adequate lighting, and using assistive devices, and by preventing complications, such as monitoring for signs of infection, bleeding, or electrolyte imbalance, and by educating the client and the family about the medications, the signs and symptoms of HF worsening, and the emergency measures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is incorrect because any exertion on the part of an older adult with heart disease does not necessarily result in death. Exertion can increase the oxygen demand of the heart and cause angina, or chest pain, but it can also be beneficial for the cardiovascular health and fitness of the older adult, if done within the limits of their tolerance and under medical supervision.
Choice B reason: This is incorrect because myocardial infarction is not the same as heart attack, cardiac arrest, or coronary thrombosis, although they are related terms. Myocardial infarction is the medical term for the death of a part of the heart muscle due to lack of blood supply. Heart attack is the common term for myocardial infarction. Cardiac arrest is the sudden loss of heart function, which can be caused by myocardial infarction or other factors. Coronary thrombosis is the formation of a blood clot in a coronary artery, which can lead to myocardial infarction.
Choice C reason: This is correct because both excessive undernutrition and overnutrition can contribute to heart disease. Undernutrition can cause malnutrition, anemia, and low immunity, which can increase the risk of infections and inflammation that can damage the heart. Overnutrition can cause obesity, diabetes, and high cholesterol, which can increase the risk of atherosclerosis and hypertension that can impair the blood flow to the heart.
Choice D reason: This is incorrect because a person with diabetes should have their blood pressure checked regularly, but this is not a statement about heart disease in Kenya. Diabetes is a risk factor for heart disease, as it can damage the blood vessels and nerves that control the heart. However, this statement is applicable to any person with diabetes, regardless of their location.
Correct Answer is ["A","B"]
Explanation
Choice A reason: Sudden onset of symptoms is a sign of hyperthyroidism, as it indicates a rapid increase in thyroid hormone levels that can cause a thyroid storm, a life-threatening condition that requires immediate medical attention. Symptoms of a thyroid storm may include fever, agitation, confusion, sweating, nausea, vomiting, diarrhea, and chest pain.
Choice B reason: Atrial fibrillation is a sign of hyperthyroidism, as it indicates an irregular and fast heartbeat that can result from the excess stimulation of the heart by thyroid hormones. Atrial fibrillation can increase the risk of blood clots, stroke, and heart failure.
Choice C reason: Cold intolerance is not a sign of hyperthyroidism, but rather a sign of hypothyroidism, a condition where the thyroid gland produces too little thyroid hormone. Cold intolerance means feeling cold even in warm environments, due to the reduced metabolic rate and heat production.
Choice D reason: Constipation is not a sign of hyperthyroidism, but rather a sign of hypothyroidism, a condition where the thyroid gland produces too little thyroid hormone. Constipation means having difficulty passing stools, due to the slowed intestinal motility and digestion.
Choice E reason: Heart failure is not a sign of hyperthyroidism, but rather a complication of hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone. Heart failure means the inability of the heart to pump enough blood to meet the body's needs, due to the increased workload and damage to the heart muscle.
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