A 78-year-old client is admitted to the Emergency Department who ...

[vicky]

A 78-year-old client is admitted to the Emergency Department who has an unsteady gait and appears to be confused. For which event should the nurse assess if this client has recently experienced?
 
  1. A respiratory infection
  2. A death of a loved one
  3. Difficulty swallowing
  4. Diarrhea

Question 2

The nurse is teaching a client about the effects of taking in increased amounts of sodium. The nurse explains that a hypertonic solution results from excessive intake of sodium, which causes the cells of the body to:
 
  1. neither gain nor lose water.
  2. absorb water, swell, and, eventually burst.
  3. lose water and shrink.
  4. leak out of the area they are in.

[joewallace]

Answer to Question 1

Answer: 4

1. There is no evidence that the client has experienced a respiratory infection, which usually does not affect an elderly client's gait and thinking.
2. The nurse would expect the client to be sad if a death had occurred.
3. Difficulty swallowing does not cause an unsteady gait or confusion.
4. Diarrhea is a reason for fluid volume deficit. An elderly client can become dehydrated very quickly with only a 1 to 2 fluid loss. Symptoms seen would be confusion and physical performance such as an unsteady gait.

Answer to Question 2

Answer: 3

1. Cells do not gain or lose water in an isotonic solution, which is the norm in the body.
2. In hypotonic or low-sodium solutions, cells swell and burst.
3. In hypertonic solutions, water is drawn from the cells because of high sodium levels outside the cell, and the cells shrivel.
4. Cells in tissues do not move from their area. However, blood cells can move at times.