The nurse plans activities for female elders born between 1920 ...

[KimWrice]

The nurse plans activities for female elders born between 1920 and 1930 and who reside in an assisted-living facility. Which is the best intervention for the nurse to implement?
 
  a. Have them bake cookies twice a week.
  b. Conduct interviews for specific interests.
  c. Arrange dog and cat visits from volunteers.
  d. Take them to the library for guest speakers.

Question 2

An older adult who has an albumin level of 2.5 g/dl takes aspirin and phenytoin (Dilantin) by mouth daily. Which adverse effect of these medications does the nurse expect because of the older adult's nutritional status?
 
  a. Depressed mood
  b. Clay-colored stools
  c. Increased heart rate
  d. Gingival hyperplasia

[Viet Thy]

Answer to Question 1

B

Feedback
A Incorrect. Because most of these women are in their 80s, and women born be-tween 1920 and 1930 generally spent their lives as homemakers, the nurse pre-sumes to know what activities they will enjoy.
B Correct. The nurse conducts individual interviews with the elders to determine their interests and avoids generalizing, because as people live longer, they be-come more and more unique.
C Incorrect. The nurse avoids arranging group activities until individual interests are determined. In addition, the nurse must assess for allergies and individual fears of animals before exposing an elder to a pet visit.
D Incorrect. Unless it is done on a voluntary basis, the nurse avoids arranging visits by guest speakers. In addition, the nurse assesses each elder before outside visits to avoid embarrassing events including incontinence and hearing and vision problems.

Answer to Question 2

B

Feedback
A Incorrect. Depression is a common adverse effect of antiseizure medication, es-pecially phenytoin, but is unrelated to hypoalbuminemia.
B Correct. Serum albumin at 2.5 g/dl is below normal, indicating that the older adult has hypoproteinemia. The medication is partially inactivated after absorp-tion because a percentage of it binds with serum proteins, especially albumin. If the older adult does not have an adequate serum albumin level, a greater per-centage of active medication circulates in the blood stream since an insufficient amount of albumin is available for binding; thus toxic levels can develop. When aspirin is taken by an individual, the inactivated form is excreted by the kidneys, and the liver metabolizes the active compound. However, an older adult with hypoalbuminemia exposes the liver to potentially toxic levels of aspirin that can lead to hepatotoxicity as evidenced by clay-colored stools.
C Incorrect. Tachycardia is not a commonly associated adverse effect of aspirin or phenytoin.
D Incorrect. Gingival hyperplasia is a common adverse effect of phenytoin, but it does not indicate toxicity, and it is unrelated to hypoalbuminemia.

[KimWrice]

Excellent

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