Asthma
Asthma is often underdiagnosed in older adults because:
a.older adults frequently do not have any of the classic signs and symptoms.
b.symptoms of asthma are often attributed to normal age-related changes.
c.asthma is very uncommon in older adults.
d.asthma symptoms are usually very mild in older adults.
b.symptoms of asthma are often attributed to normal age-related changes.
The three cardinal symptoms of COPD:
Chronic cough, dyspnea, and sputum production
Aspiration pneumonia can result from:
1) aspiration of colonized saliva
2) aspiration of colonized materials ingested or retained in the pharynx
3) aspiration of gastro-esophageal contents (pneumonitis)
An elderly client reports to the nurse that he has experienced a 15-pound weight loss over the last two months and can no longer wear his dentures. Which of the following would be the priority nursing diagnosis for the nurse to address?
A. Impaired dentition related to poorly fitting dentures
B. Impaired oral mucous membranes related to recent weight loss
C. Imbalanced nutrition: more than body requirements
D. Social isolation related to recent weight loss
A. Impaired dentition related to poorly fitting dentures
Failure to thrive is defined as?
Ongoing State of Decline
Multifactorial
Chronic Concurrent Diseases
Functional Disarrays such as declining Activities of Daily Living and Impaired Instrumental Activities of Daily Living
What is a report that provides great strategies for the management and prevention of asthma?
Global Initiative for Asthma (GINA)
The most significant etiology for COPD __
Tobacco Use
General Risk Factors - Aspiration Pneumonia:
- chronic heart failure
- COPD
- multiple meds (esp. sedating)
- feeding dependence
- poor oral hygiene
- smoking
- use of suctioning (reflects that pt can't manage own secretions)
*NOT necessarily dysphagia
While conducting a health assessment, the nurse practitioner asks about the three pillars of food security. This includes which of the following?
a. Food allocation.
b. Food availability.
c. Food that is inexpensive.
d. Food freshness.
b. Food availability.
. Mrs. Odom is 70 years old and has experienced a major stroke. She has been cared for at home and her family reports that she is declining. She is cognitive but is weakening, and has lost much weight. The nurse practitioner suspects a nutritional disorder-refeeding syndrome. The nurse practitioner assesses for which of the following? Select all that apply.
a. BMI of 17.
b. Unintentional weight loss within the last 3 months.
c. No nutritional intake in the last 5 days.
d. Blood values for vitamins A, D, E, and K.
e. Increase in serum phosphate.
a. BMI of 17.
b. Unintentional weight loss within the last 3 months.
c. No nutritional intake in the last 5 days.
True or False
Asthma is commonly progressive and symptoms deteriorate over time
False - This is more of COPD
A nurse practitioner is caring for a 90-year-old adult with asthma who has comorbid dementia and severe osteoarthritis in the hands. The nurse practitioner considers inhaled medications to manage asthma. Which of the following factors should the nurse take into consideration when developing the medication plan for this patient? (Select all that apply.)
a.The patient's ability to swallow safely
b.The patient's manual dexterity
c.The patient's age
d.The patient's cognitive status
e.The patient's mobility status
b.The patient's manual dexterity
d.The patient's cognitive status
Which lobe do aspirated contents typically gather?
Why?
R lobe; right lower lobe is a straight line of descent from the trachea
A primary goal of dietary intervention for the older adult is to:
A. Prevent complications from chronic conditions.
B. Improve digestion and metabolism.
C. Maintain quality of life.
D. Treat acute conditions.
C. Maintain quality of life.
Rationale: Dietary assessment and early intervention can improve the overall quality of life and possibly prevent disease or illness. Most acute conditions are not treated primarily by dietary intervention. Digestion occurs in the GI tract and metabolism occurs at the cellular level.
A major predictor of morbidity and mortality in the elderly is:
A. Social isolation.
B. Polypharmacy.
C. Impaired dentition.
D. Unintentional weight loss.
D. Unintentional weight loss.
List a medication that could benefit patients with asthma and co-occurring allergic rhinosinusitis
Intranasal, inhaled glucocorticoids
Oral antihistamines
Leukotriene inhibitors
Post-bronchodilator FEV1-FVC less than _ establishes the presence of COPD
__________ aspiration is the penetration of food, liquid, or saliva to the subglottic area without the elicitation of a cough.
Silent
One of the challenges in meeting the nutritional needs of the older adult is that the older adult:
A. Have decreased need for almost all nutrients.
B. Have decreased caloric needs but constant or increased needs for vitamins and minerals.
C. All have significant problems with dentition that affect their ability to masticate most food.
D. Lose interest in eating a balanced diet.
B. Have decreased caloric needs but constant or increased needs for vitamins and minerals.
. Mr. Abernathy is irritated with his daughter for insisting that he eat more food. He says that he is not hungry and wants to be left alone. The nurse practitioner recommends which of the following? Select all that apply.
1. An appetite suppressant.
2. A multidisciplinary team evaluation.
3. Providing appropriate food that he prefers.
4. Placing a percutaneous endoscopic gastrostomy (PEG) tube until he eats orally.
5. Providing nutritional supplements until he begins to eat again.
2. A multidisciplinary team evaluation.
3. Providing appropriate food that he prefers.
Mary, 72 years old, goes to the pharmacy to pick up her prescriptions for her Asthma. The pharmacist asks if she has had her immunizations. For Mary and her diagnosis of Asthma, what vaccines would the pharmacist be referring to the most? (select all the apply)
a. Influenza
b. COVID-19
c. Shingrix
d. Pneumoncoccal
A, B, D
There are __ classes of COPD, what are they?
4 classes
Mild, Moderate, Severe, Very Severe
An appropriate dietary intervention for an elderly client with dysphagia is to:
A. Serve smaller, more frequent meals.
B. Serve foods at room temperature.
C. Provide a full liquid diet.
D. Thicken thin liquids.
D. Thicken thin liquids.
For an elderly client who is experiencing chronic nausea and weight loss, which laboratory result would the nurse recognize as being most consistent with a diagnosis of Imbalanced Nutrition: Less Than Body Requirements?
A. Serum glucose of 78 mg/dL
B. Serum albumin of 3.2 g/dL
C. Creatinine of 1.0 mg/dL
D. Potassium of 4.1 g/dL
B. Serum albumin of 3.2 g/dL
A 68-year-old patient has sustained an unintended weight loss of 15 lb (6.8 kg) over the last two months but reports feeling well. The patient's problems include depression, tobacco abuse, obesity, and dyslipidemia. His or her medications are sertralizine (Zoloft), simvastatin (Zocor), and famotidine (Pepcid). The adult-gerontology primary care nurse practitioner performs which THREE actions?
(a) Adds a probiotic.
(b) Conducts a depression screening.
(c) Decreases the dosage of the statin medication.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.
(b) Conducts a depression screening.
(d) Obtains a chest x-ray.
(e) Orders a thyroid-stimulating hormone.