The wife of an older client is concerned that her husband has ...

[Zoey63294]

The wife of an older client is concerned that her husband has recently experienced memory lapses, is unusually aggressive and was involved in three traffic accidents in the past month.
 
  In planning a response, the nurse is guided by the knowledge that: 1. Further intervention is needed to prevent elder abuse of the wife.
  2. Further assessment is needed to determine if alcohol abuse is possible.
  3. These are normal responses to aging.
  4. These are signs of depression or dementia.

Question 2

A client has come to a nurse practitioner with concerns about health care costs.
 
  The client, who had one myocardial infarction and later suffered from severe anxiety, asks for a plan of care that includes appropriate complementary and alternative therapies. Which of the following CAM modalities is not appropriate for someone with a history of cardiac problems? 1. Massage
  2. Moderate exercise
  3. Active progressive relaxation
  4. Finger-holds for general well-being

[brittrenee]

Answer to Question 1

2
Rationale: Alcohol abuse is often overlooked and untreated in older adults. Additionally, elders are more vulnerable to the effects of alcohol and are the largest consumers of OTC and prescribed medications. Aggressive behavior and memory lapses are not normal responses to aging and may be signs of depression or dementia; however, further assessment is needed before any diagnosis can be made. Elder abuse of the wife, although possible, is not apparent and the nurse should not assume intervention is necessary without further assessment.

Answer to Question 2

3
Rationale: Clients with cardiac problems may be at increased risk for cardiac arrhythmia because of vasovagal stimulation with certain techniques such as active progressive relaxation. Depending upon client preferences, massage can be a beneficial stress management tool. Finger-holds for general well-being is a form of acupressure and has the potential to bring the anxious client into a moderate meditative state that is not so deep as to cause a vasovagal stimulation. Moderate exercise, as prescribed by one's physician, is a known self-care management technique in cardiac rehabilitation.