A nurse measures an older adult's blood pressure on the right arm ...

[kshipps]

A nurse measures an older adult's blood pressure on the right arm and notes a reading of 150/100. The nurse waits 5 minutes and measures the blood pressure again in the right arm and obtains a reading of 152/100. What is the next action by the nurse?
 
  a. Immediately contact the medical provider.
  b. Measure the blood pressure in the left arm.
  c. Measure the blood pressure in sitting and standing positions.
  d. Document the findings in the medical rec-ord; elevated blood pressures are normal in older adults.

Question 2

A nurse is caring for an older hospitalized patient who recently suffered a myocardial infarction (MI). The patient asks the nurse, I didn't even know that I had a heart attack. I did not have crushing chest pain like you see on television.
 
  Why didn't I? The best response by the nurse is:
  a. Older patients do not feel pain in the same way that younger patients do.
  b. Oh, that is just television. Hardly anyone has crushing chest pain when he has a heart attack.
  c. Older people often do not have the typi-cal signs and symptoms when they have a heart attack.
  d. Older people never have chest pain when they have a heart attack.

[sarajane1989]

Answer to Question 1

ANS: B
When an abnormal blood pressure reading is obtained, it is necessary to do two measurements, five minutes apart, confirmed in the contralateral arm. Doing orthostatic measurements is not in-dicated in this situation. A blood pressure reading above 140/90 is considered abnormal for an older adult.

Answer to Question 2

ANS: C
Symptoms of an MI can be completely atypical in an older person, such as an unexplained fall, acute change in mental status, or extreme fatigue or dyspnea. Some older patients, however, do have the typical signs and symptoms. It is not true that older people do not feel pain.