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The middle adult is sometimes called the “sandwich generation”. According to Erikson, the developmental task of the middle adult is:
generativity versus stagnation - The developmental task of the middle adult is generativity versus stagnation. They are in a stage of guiding the next generation, accepting their own changes and adjusting to need of aging parents, as well as evaluating their own goals and accomplishments. Ego integrity versus despair is the developmental task for older adults.
Which of the following assessment findings of a 77-year-old male patient should signal the nurse to a potentially pathologic finding rather than a normal age-related change?
The patient is oriented to person and place but is unsure of the month.Explanation:Age-related physiologic changes include a weakening of bladder emptying, presbycusis, and a slow gait that may be accompanied by stooped posture. Disorientation to time, however, should always prompt the nurse to perform further assessment and should never be considered a normal accompaniment to the aging process.
Nurses care for individuals from many cultures and various social-economic levels. The most unique population in society today is which of the following?
The older adult population because they have lived longer and have managed complex changes in society.
The strains of providing care for an elderly family member with a chronic condition can sometimes be more than the family or caregiver can bear. If the nurse suspects that there is a potential problem with abuse of an elderly person preventive measures should be taken. What might early detection and prevention provide for this potential problem?
Sufficient resources to decrease risk for patient safety.Explanation:Nurses should be alert to possible elder abuse and neglect. During the health history, the elderly person should be asked about abuse during a private portion of the interview. Most states require that care providers, including nurses, report suspected abuse. Preventive action should be taken when caregiver strain is evident, before elder abuse occurs. Early detection and intervention may provide sufficient resources to the family or person at risk to ensure patient safety.
You are assessing a 48-year-old, middle-aged adult in the clinic. You recall the changes that occur in middle age as you complete your physical and cognitive examination. Changes that occur include:
Cardiac output decreases.Explanation:Middle age changes include redistribution of fatty tissue around the middle and abdomen, drier skin, wrinkles develop and hair grays, and men may experience baldness, cardiac output decreases, near-vision diminishes, presbyopia, hearing diminishes especially high-pitched sounds, hormone levels decrease, calcium loss from bone occurs, and a decrease in muscle strength.
You are assigned to care for an 87-year-old patient admitted to the medical unit for congestive heart failure. It is the fourth hospital day, and the response to treatment has been good. The patient is no longer short of breath and the lung sounds are clearing. There is still a diet restriction of decreased sodium and limiting fluids to no more than 1000 mL per day. You are preparing the patient and family for discharge. Your discharge teaching in order to promote the older patient’s health will include which of the following? Select all that apply.
- • Gradually increase activities as tolerated.
- • Do not use the salt shaker at meals.
- • Increased stress may interfere with recovery.
A nurse at a long-term care facility is working to develop a program to promote regular medical check-ups for the residents to minimize the risk of infection. When proposing this program to the facility's governing board, which of the following would the nurse emphasize as the underlying rationale for this type of program?
The antibody response in older adults is lower placing them at increased risk. Explanation:Older adult clients are prone to infections due to a lower antibody response toward microorganisms. Inadequate nutrition and the presence of chronic illnesses adversely affect the immune system and the ability to ward off infection. Older adults are predisposed to infection due to a decrease in T-cell function. (immunosenescence/immunity theory of aging) Sleep disturbances do not directly affect the immunity of the older adult client.
myths of the older adult
include old age begins at 65, most older adults are in nursing homes, most are sick, mental deterioration occurs, they are not interested in sex, are isolated and lonely, have bladder problems, and do not deserve aggressive treatment in serious illness.
When completing your assessment of the middle-aged adult, you make note of his cognitive development. You would expect to find:
increased motivation to learn.Explanation:Cognitive changes such as intelligence change throughout life. The middle aged adult may begin to take a little longer to respond, related to more memories and information to process, They are often more motivated to learn especially relevant and applicable information.
A nurse is developing a plan of care for a client who recently lost his spouse. Which of the following would be most appropriate for the nurse to suggest to help the client cope with his loss?
Seeking support from his faithExplanation:Seeking support from the client's faith is an adaptive means of coping with loss. Social support and therapy are other methods of adaptive coping. Although remaining active in the community fosters social connection, the client may find it difficult to do so. Remaining active does aid in addressing loneliness. Maintaining nutrition promotes the health of the older adult but does not affect coping. Validating his needs is a treatment strategy used with clients experiencing dementia.
While providing hygiene care to a confused elderly patient diagnosed with Alzheimer's disease, you are called to the nursing station. To ensure patient safety you must:
put side rails up before leaving the patient.
When caring for the older adult, it is the nurse's responsibility to assess for maltreatment. When assessing an older adult on a home care visit, the nurse is aware that the primary perpetrator of elder abuse is:
A home care nurse visits an older adult client with dementia due to Alzheimer's disease. As a result of the client's confused thinking, the client is experiencing significant difficulty in communicating with family members. Which intervention would be most appropriate for this client?
- Validate the client's current needs
- Explanation:The nurse should use validation therapy, that is, validate the client's current needs to facilitate communication and minimize the adverse consequences of confused thinking. Validation therapy is a type of interpersonal interaction in which the health professional attempts to understand and validate the client's current needs. Reality orientation is recommended for orienting people with reversible confusional states. Providing appropriate sensory appliances like glasses and hearing aids, and maintaining levels of sensory stimulation, are not helpful in dementia or irreversible confusion.
Which of the following health promotion measures should occur most frequently in older adult women?
Fecal occult blood testExplanation:Fecal occult blood tests are recommended annually for older adults. Pap exams and pelvic exams are recommended at least every 3 years. Colonoscopy or sigmoidoscopy should be performed every 3 to 5 years, and a tetanus booster is only necessary every 10 years.
Most older adults gradually modify activities or lifestyle to accommodate for declines in strength and health. The nurse recognizes the need for older adults to maintain activity and exercise in order to preserve all physiologic functions. When encouraging activity, it is important to consider which of the following:
- • Chronic illness often accompanies aging.
- • There is an increased risk of sleep disorders.
- • Assistive devices help to maintain mobility and safety.
- Explanation:The physical strength and health of the older adult declines and requires lifestyle modifications. Older adults have more chronic illness and have the potential for sleep disruptions and the increased risk of falls, thus the need for a cane/walker for assistance. Pain should not be assumed to be a normal consequence of aging.
An elderly patient is being treated with a tricyclic antidepressant medication. What adverse reaction should the home care nurse observe for?
Atrial fibrillation Explanation: Tricyclic antidepressants may induce arrhythmias or may worsen pre-existing heart failure.
You are the nurse caring for an elderly patient who is confused and agitated. When the patients’ family comes to visit the patient you ask them how long the patient has been confused. The family states that the patient has been confused for a long time and the confusion is getting worse. The patient is subsequently diagnosed with dementia. What is the most common cause of dementia in an elderly patient?
A home care nurse is reviewing guidelines for health-related screenings with a 35-year-old patient. What are common screening recommendations for physical examinations?
Every 3 years to age 40 and annually from age 40
A public health nurse is participating in a health fair that is being held at a local community center. The nurse should encourage adult participants to completely eliminate which of the following from their diet and lifestyle?
SmokingExplanation:Alcohol, salt, and cholesterol all have the potential to cause harm when used in excess. However, moderate and conscientious intake of each is not unhealthy, and complete elimination of cholesterol or salt from the diet would in fact be harmful. Smoking, however, is never a benign activity and even "moderate" smoking should be discontinued.
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