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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.
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A gerontologic nurse has been working hard to change the perceptions of the elderly, many of which are negative, by other segments of the population. What negative perceptions of older people have been identified in the literature? Select all that apply.
- A. As being the cause of social problems
- B. As not contributing to society
- C. As draining economic resources
- D. As competing with children for resources
- E. As dominating health care research
Correct Answer: B,C,D
Rationale: Retirement and perceived nonproductivity are responsible for negative feelings because a younger working person may falsely see older people as not contributing to society and as draining economic resources. Younger working people may actually feel that older people are in competition with children for resources. However, the older population is generally not seen as dominating health care research or causing social problems.
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 providing patient teaching to a patient with early stage Alzheimers disease (AD) and her family. The patient has been prescribed donepezil hydrochloride (Aricept). What should the nurse explain to the patient and family about this drug?
- A. It slows the progression of AD.
- B. It cures AD in a small minority of patients.
- C. It removes the patients insight that he or she has AD.
- D. It limits the physical effects of AD and other dementias.
Correct Answer: A
Rationale: There is no cure for AD, but several medications have been introduced to slow the progression of the disease, including donepezil hydrochloride (Aricept). These medications do not remove the patients insight or address physical symptoms of AD.
An occupational health nurse overhears an employee talking to his manager about a 65 -year-old coworker. What phenomenon would the nurse identify when hearing the employee state, He should just retire and make way for some new blood.?
- A. Intolerance
- B. Ageism
- C. Dependence
- D. Nonspecific prejudice
Correct Answer: B
Rationale: Ageism refers to prejudice against the aged. Intolerance is implied by the employees statement, but the intolerance is aimed at the coworkers age. The employees statement does not raise concern about dependence. The prejudice exhibited in the statement is very specific.
A gerontologic nurse is basing the therapeutic programs at a long-term care facility on Millers Functional Consequences Theory. To actualize this theory of aging, the nurse should prioritize what task?
- A. Attempting to control age-related physiological changes
- B. Lowering expectations for recovery from acute and chronic illnesses
- C. Helping older adults accept the inevitability of death
- D. Differentiating between age-related changes and modifiable risk factors
Correct Answer: D
Rationale: The Functional Consequences Theory requires the nurse to differentiate between normal, irreversible age-related changes and modifiable risk factors. This theory does not emphasize lowering expectations, controlling age-related changes, or helping adults accept the inevitability of death.