A gerontological nurse conducts an assessment of an older adult ...

[CharlieWard]

A gerontological nurse conducts an assessment of an older adult who has a history of depression. Assessment reveals that the client has been drinking up to two bottles of wine each day for the last several months.
 
  What should the nurse teach the client about alcohol use and depression?
 
  A) If you choose to use alcohol to address your depression, it's best to limit it to four to five drinks each day.
  B) We recommend that everyone over the age of 70 abstain from drinking alcohol.
  C) Alcohol has been shown to contribute to depression and vice versa.
  D) If you quit drinking, your depression will likely improve.

Question 2

A nurse educator teaches about theories of late-life depression. Which of the following statements by a student shows that the material is understood?
 
  A) Adverse events impair your ability to evaluate yourself.
  B) Depression is caused by decreased activity in the hypothalamicpituita ryadrenal axis.
  C) Older adults with depression and chronic illness have more serious negative functional consequences.
  D) Researchers have identified a cause-and-effect relationship between depression and dementia.

[gasdhashg]

Answer to Question 1

Ans: C
Alcohol and depression have a synergistic relationship: alcohol causes depression, depression leads to alcohol abuse, which, in turn, exacerbates the depression. Four or five drinks daily is excessive, but abstinence is not necessary for all older adults. Abstinence is not guaranteed to improve symptoms of depression.

Answer to Question 2

Ans: C
Studies consistently find that the co-occurrence of depression with chronic conditions in older adults is associated with more serious negative functional consequences. Cognitive theory says that distorted perceptions, not adverse (unfavorable) events, impair one's ability to appraise oneself and the event constructively. Increased plasma cortisol levels and increased activity of the hypothalamicpituita ryadrenal axis can lead to depression. Researchers have identified neuropathologic changes but have not identified a specific cause-and-effect relationship between dementia and depression.