An 82-year-old resident of a long-term care facility with a ...

[ssal]

An 82-year-old resident of a long-term care facility with a recent history of repeated urinary tract infections and restlessness is suspected of having urinary retention. Which of the following actions by the care team is most appropriate?
 
  A)
  Uroflowmetry to determine the rate of the client's urine flow
  B)
  Ultrasound bladder scanning to determine the residual volume of urine after voiding
  C)
  Renal ultrasound aimed at identifying acute or chronic kidney disease
  D)
  Urinalysis focusing on the presence of or absence of microorganisms, blood, or white cells in the man's urine

Question 2

Recognizing the prevalence and incidence of dehydration among older adults, a care aide at a long-term care facility is in the habit of encouraging residents to drink even though they may not feel thirsty at the time.
 
  Which of the following facts underlies the care aide's advice?
  A)
  Older adults often experience a decrease in the sensation of thirst, even when serum sodium levels are high.
  B)
  The metabolic needs for both fluid and sodium in older adults differ from those of younger individuals.
  C)
  Regulation and maintenance of effective circulating volume by the kidneys is less effective in the elderly.
  D)
  The renin-angiotensin-aldosterone system (RAAS) is less able to facilitate sodium clearance in older adults.

[Galvarado142]

Answer to Question 1

Ans:
B

Feedback:

Ultrasound bladder scanning yields a fast and noninvasive indication of whether or not an individual is adequately emptying his or her bladder with each void. Uroflowmetry would be less indicative of whether the man is retaining, and renal ultrasound would address deficits in urine production rather than bladder emptying. Urinalysis would be useful in the diagnosis of infections and/or renal issues more than deficiencies in bladder emptying.

Answer to Question 2

Ans:
A

Feedback:

The elderly are prone to hypodipsia even when osmolality and serum sodium levels are elevated, a fact that is compounded by sensory and/or neurological deficits. Hypodipsia in the elderly is not related to differing metabolic needs, ineffective kidney function, or compromise of the RAAS.

[ssal]

Excellent

[FergA]

Gracias!