Gerontological Nursing Chapter 35

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Questions and Answers

Which of the following teaching points of the nurse is most appropriate for a 79-year-old woman with angina?

Strictly monitor her diet.

Encourage complete rest and dependency.

Limit all self-care activities.

Try to maximize the amount of self-care that your mother performs and still treat her like a responsible person. (correct)

Which of the following patients meets the criteria for being classified as frail?

Mr.A who walks daily.

Mrs.D who is active and social.

Mr.C who has lost 20 pounds in the past year, cannot grip utensils, and is inactive. (correct)

Mrs.B who has maintained her weight.

Which of the following is the most likely to prevent or postpone frailty?

Exercises for strengthening muscles (correct)

Inactivity and sedentary lifestyle

Isolation from family

Poor nutrition

Which of the following are reactions that accompany disability for most people? (Select all that apply)

Denial of disabilities by making unrealistic plans and not complying with their care plans Signup and view all the answers

Which of the following goals should be prioritized during Mr. G's rehabilitation?

Improvement in functional capacity Signup and view all the answers

What action should the nurse choose to address Mrs. Y’s challenge in checking her blood sugars?

Teach Mrs.Y a method of using a glucometer that can be performed using her unaffected hand. Signup and view all the answers

Which of the following are principles of rehabilitative nursing in gerontological nursing care? (Select all that apply)

Act for or do for when the person is unable to take action for himself or herself Signup and view all the answers

When the rehabilitative nurse focuses on the many obstacles that the client has successfully overcome, which guideline for rehabilitative care is being exhibited?

Emphasize function rather than dysfunction Signup and view all the answers

If a nurse infantilizes the client, they are not adhering to which guideline for rehabilitative nursing?

Do not equate physical disability with mental disability Signup and view all the answers

Which resident is most likely to be characterized as dependent regarding activities of daily living?

Mr.H, who needs the assistance of care staff to get off the bedpan after he voids. Signup and view all the answers

Which is most likely to keep a person from functioning independently?

Difficulty in eating Signup and view all the answers

Which of the following are typical activities of daily living? (Select all that apply)

Toileting Signup and view all the answers

Which of the following are instrumental activities of daily living related to nutritional status? (Select all that apply)

Shopping Signup and view all the answers

Which of the following are reasons that correct body alignment for the elderly rehabilitation client is so important? (Select all that apply)

Facilitates optimal function of major systems Signup and view all the answers

Which patient should stop exercising during monitored activity?

Mr.A's systolic blood pressure has increased by 25 mm Hg. Signup and view all the answers

Which of the following actions by the nurse is correct when helping a patient with range-of-motion exercises?

Offers support above and below the knee being exercised. Signup and view all the answers

Which type of range-of-motion is provided to a patient who is comatose?

Passive range of motion Signup and view all the answers

Which of the following older adults is using his or her mobility device most appropriately?

Mr.B, who says that his cane helps him stay more balanced and stable when he walks. Signup and view all the answers

For which of the following reasons should the nurse keep abreast of current assistive technology?

All of the above. Signup and view all the answers

Which question is most appropriate for providing reality orientation for a patient with stage 5 Alzheimer's disease?

Are you looking forward to Thanksgiving next week, Mr.Hall? Signup and view all the answers

How should the director of a nursing home handle residents who refuse to play Bingo, claiming it is a waste of time?

Continue the games but offer an alternative activity that provides more mental stimulation. Signup and view all the answers

Which aid to reality orientation can most help elderly patients?

Conversations Signup and view all the answers

What are the therapeutic effects of reminiscence? (Select all that apply)

It is a means of validating existence. Signup and view all the answers

What is the most important skill for nurses to use in reminiscing activities?

Listening Signup and view all the answers

To what resource(s) should the nurse direct the wife of a 74-year-old post-stroke patient to aid in his functional recovery?

A social worker and rehabilitation counselor Signup and view all the answers

Which of the following professionals can offer guidance in locating appropriate resources? (Select all that apply)

Social workers Signup and view all the answers

Study Notes

Nursing Care for the Elderly

Encourage self-care in elderly patients to enhance their autonomy and responsibility, as seen in the case of a 79-year-old woman with angina.
Identify frailty in elderly patients, exemplified by Mr. C, who has significant weight loss and decreased functional abilities.
Strengthening exercises are essential to prevent or delay frailty among elderly individuals.

Reactions to Disability

Common emotional responses to disability include mourning losses, denial, anger, and fluctuating emotions.

Rehabilitation Goals

Prioritize improvement in functional capacity during rehabilitation for patients, like Mr. G, recovering from hip surgery.

Assistive Techniques

Adapt tools like glucometers for elderly patients with disabilities, such as Mrs. Y, using her unaffected hand for blood sugar checks.

Principles of Rehabilitation

Focus on increasing self-care capability and minimizing limitations, acting on behalf of those unable to self-advocate.

Emphasis on Functionality

Shift focus from dysfunction to functional achievements in rehabilitation to empower clients.

Proper Client Interaction

Avoid infantilizing clients by separating physical disabilities from cognitive abilities to support independence.

Dependence in Daily Activities

Identify dependent residents, such as Mr. H, who requires assistance with basic tasks like using the bedpan.

Activities of Daily Living (ADLs)

Recognize typical ADLs: eating, dressing, toileting, and moving.

Instrumental Activities of Daily Living (IADLs)

Understand IADLs related to nutrition: shopping, cooking, and cleaning the kitchen.

Body Alignment Importance

Correct body alignment is crucial as it facilitates optimal bodily function, enhances patient comfort, and prevents complications.

Monitoring Exercise

Monitor vital signs during exercise; a significant systolic blood pressure increase in Mr. A during cycling indicates a need to stop.

Range of Motion Exercises

Support patients properly during range-of-motion exercises, ensuring safety and effectiveness.

Mobility Devices

Proper use of mobility devices, like canes, enhances balance and stability in elderly patients, evident in Mr. B's experience.

Awareness of Assistive Technology

Stay updated on assistive technologies to enable elderly patients in self-care, community functioning, and workplace participation.

Reality Orientation in Alzheimer's

Use targeted questions like discussing upcoming events to enhance reality orientation for patients with advanced Alzheimer's, such as Mr. Hall.

Engagement Activities

Provide stimulating activities like Bingo while also offering alternatives for those who may refuse participation.

Benefits of Reminiscence

Reminiscence provides therapeutic benefits including validation of existence, conflict resolution, and finding meaning in life.

Key Skills in Reminiscence

Listening is a vital skill for nurses during reminiscing activities to strengthen patient engagement.

Support for Caregivers

Refer caregivers of elderly patients to social workers and rehabilitation counselors for better support and recovery outcomes.

Professional Guidance Resources

Utilize professionals such as social workers, physical therapists, occupational therapists, and speech/hearing therapists for resource guidance.

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Description

Explore key concepts from Chapter 35 of Eliopoulos' Gerontological Nursing. This quiz focuses on providing appropriate nursing care and teaching points for elderly patients, especially concerning their mobility and quality of life. Test your knowledge on best practices for fostering well-being in older adults.