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An 84-year-old patient has returned from the post-anesthetic care unit (PACU) following hip arthroplasty. The patient is oriented to name only. The patients family is very upset because, before having surgery, the patient had no cognitive deficits. The patient is subsequently diagnosed with postoperative delirium. What should the nurse explain to the patients family?
- A. This problem is self-limiting and there is nothing to worry about.
- B. Delirium involves a progressive decline in memory loss and overall cognitive function.
- C. Delirium of this type is treatable and her cognition will return to previous levels.
- D. This problem can be resolved by administering antidotes to the anesthetic that was used in surgery.
Correct Answer: C
Rationale: Surgery is a common cause of delirium in older adults. Delirium differs from other types of dementia in that delirium begins with confusion and progresses to disorientation. It has symptoms that are reversible with treatment, and, with treatment, is short term in nature. It is patronizing and inaccurate to reassure the family that there is nothing to worry about. The problem is not treated by the administration of antidotes to anesthetic.
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The case manager is working with an 84-year-old patient newly admitted to a rehabilitation facility. When developing a care plan for this older adult, which factors should the nurse identify as positive attributes that benefit coping in this age group? Select all that apply.
- A. Decreased risk taking
- B. Effective adaptation skills
- C. Avoiding participation in untested roles
- D. Increased life experience
- E. Resiliency during change
Correct Answer: B,D,E
Rationale: Because changes in life patterns are inevitable over a lifetime, older people need resiliency and coping skills when confronting stresses and change. It is beneficial if older adults continue to participate in risk taking and participation in new, untested roles.
Nurses and members of other health disciplines at a states public health division are planning programs for the next 5 years. The group has made the decision to focus on diseases that are experiencing the sharpest increases in their contributions to the overall death rate in the state. This team should plan health promotion and disease prevention activities to address what health problem?
- A. Stroke
- B. Cancer
- C. Respiratory infections
- D. Alzheimers disease
Correct Answer: D
Rationale: In the past 60 years, overall deaths, and specifically, deaths from heart disease, have declined. Recently, deaths from cancer and cerebrovascular disease have declined. However, deaths from Alzheimers disease have risen more than 50% between 1999 and 2007.
A nurse is caring for an 86-year-old female patient who has become increasingly frail and unsteady on her feet. During the assessment, the patient indicates that she has fallen three times in the month, though she has not yet suffered an injury. The nurse should take action in the knowledge that this patient is at a high risk for what health problem?
- A. A hip fracture
- B. A femoral fracture
- C. Pelvic dysplasia
- D. Tearing of a meniscus or bursa
Correct Answer: A
Rationale: The most common fracture resulting from a fall is a fractured hip resulting from osteoporosis and the condition or situation that produced the fall. The other listed injuries are possible, but less likely than a hip fracture.
You are the nurse caring for an elderly patient who is being treated for community-acquired pneumonia. Since the time of admission, the patient has been disoriented and agitated to varying degrees. Appropriate referrals were made and the patient was subsequently diagnosed with dementia. What nursing diagnosis should the nurse prioritize when planning this patients care?
- A. Social isolation related to dementia
- B. Hopelessness related to dementia
- C. Risk for infection related to dementia
- D. Acute confusion related to dementia
Correct Answer: D
Rationale: Acute confusion is a priority problem in patients with dementia, and it is an immediate threat to their health and safety. Hopelessness and social isolation are plausible problems, but the patients cognition is a priority. The patients risk for infection is not directly influenced by dementia.
The nurse is caring for a 65 -year-old patient who has previously been diagnosed with hypertension. Which of the following blood pressure readings represents the threshold between high-normal blood pressure and hypertension?
- A. 140 / 90 mm Hg
- B. 145 / 95 mm Hg
- C. 150 / 100 mm Hg
- D. 160 / 100 mm Hg
Correct Answer: A
Rationale: Hypertension is the diagnosis given when the blood pressure is greater than 140 / 90 mm Hg. This makes the other options incorrect.