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Falls, which are a major health problem in the elderly population, occur from multifactorial causes. When implementing a comprehensive plan to reduce the incidence of falls on a geriatric unit, what risk factors should nurses identify? Select all that apply.
- A. Medication effects
- B. Overdependence on assistive devices
- C. Poor lighting
- D. Sensory impairment
- E. Ineffective use of coping strategies
Correct Answer: A,C,D
Rationale: Causes of falls are multifactorial. Both extrinsic factors, such as changes in the environment or poor lighting, and intrinsic factors, such as physical illness, neurologic changes, or sensory impairment, play a role. Mobility difficulties, medication effects, foot problems or unsafe footwear, postural hypotension, visual problems, and tripping hazards are common, treatable causes. Overdependence on assistive devices and ineffective use of coping strategies have not been shown to be factors in the rate of falls in the elderly population.
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A gerontologic nurse is aware of the demographic changes that are occurring in the United States, and this affects the way that the nurse plans and provides care. Which of the following phenomena is currently undergoing the most rapid and profound change?
- A. More families are having to provide care for their aging members.
- B. Adult children find themselves participating in chronic disease management.
- C. A growing number of people live to a very old age.
- D. Elderly people are having more accidents, increasing the costs of health care.
Correct Answer: C
Rationale: As the older population increases, the number of people who live to a very old age is dramatically increasing. The other options are all correct, but none is a factor that is most dramatically increasing in this age group.
You are providing care for an 82-year-old man whose signs and symptoms of Parkinson disease have become more severe over the past several months. The man tells you that he can no longer do as many things for himself as he used to be able to do. What factor should you recognize as impacting your patients life most significantly?
- A. Neurologic deficits
- B. Loss of independence
- C. Age-related changes
- D. Tremors and decreased mobility
Correct Answer: B
Rationale: This patients statement places a priority on his loss of independence. This is undoubtedly a result of the neurologic changes associated with his disease, but this is not the focus of his statement. This is a disease process, not an age-related physiological change.
Older people have many altered reactions to disease that are based on age-related physiological changes. When the nurse observes physical indicators of illness in the older population, that nurse must remember which of the following principles?
- A. Potential life-threatening problems in the older adult population are not as serious as they are in a middle-aged population.
- B. Indicators that are useful and reliable in younger populations cannot be relied on as indications of potential life-threatening problems in older adults.
- C. The same physiological processes that indicate serious health care problems in a younger population indicate mild disease states in the elderly.
- D. Middle-aged people do not react to disease states the same as a younger population does.
Correct Answer: B
Rationale: Physical indicators of illness that are useful and reliable in young and middle-aged people cannot be relied on for the diagnosis of potential life-threatening problems in older adults. Option A is incorrect because a potentially life-threatening problem in an older person is more serious than it would be in a middle-aged person because the older adult does not have the physical resources of the middle-aged person. Physical indicators of serious health care problems in a young or middle-aged population do not indicate disease states that are considered mild in the elderly population. It is true that middle-aged people do not react to disease states the same as a younger population, but this option does not answer the question.
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.
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.