After an assessment the nurse is concerned that an older patient ...

[newbem]

After an assessment the nurse is concerned that an older patient is at risk for developing pneumonia. What age-related changes did the nurse assess to make this clinical decision?
 
  Select all that apply.
 
  1. Weak cough
  2. Poor skin turgor
  3. Smoked a ppd for 30 years
  4. Body mass index 22.6
  5. Diagnosed with right-sided heart failure

Question 2

After reviewing the medical history, the nurse suspects that a 68-year-old patient would benefit from another dose of the pneumococcus vaccination. What information did the nurse use to make this clinical decision?
 
  Select all that apply.
 
  1. Initial vaccination at age 55
  2. Taking medications for hypertension
  3. Ongoing treatment for prostate cancer
  4. History of two hip replacement surgeries
  5. Beginning dialysis for chronic renal failure

[connor417]

Answer to Question 1

Correct Answer: 1, 2, 3, 5
Several changes associated with aging and disease affect respiratory function and airway clearance. The number of cilia decreases, and the cough weakens. The older adult is at greater risk for dehydration, leading to thick, viscous mucus that is difficult to expectorate. Poor skin turgor is an indication of dehydration. Other factors also may increase the risk for and severity of lower respiratory infections in the older adult including smoking history and heart disease. Malnutrition may increase the risk; however, a BMI of 22.6 is considered a normal weight.

Answer to Question 2

Correct Answer: 1, 3, 5
Pneumococcal vaccine, made of antigens from 23 types of pneumococcus, usually imparts lifetime immunity with a single dose. A one-time revaccination is recommended for selected populations, including people over age 65 that were immunized more than 5 years previously and before age 65, people with chronic renal failure or immunosuppressive conditions such as cancer. Treatment for hypertension and joint replacement surgery do not increase this patient's risk of developing pneumonia.