An older woman has diabetes mellitus. Which patient assessment ...

[Bernana]

An older woman has diabetes mellitus. Which patient assessment validates the nurse's conclusion that she is in the foreground perspective of the shifting perspectives model of chronic illness?
 
  a. Has an amputation of two toes.
  b. Lives at home with her husband.
  c. Frequently self-checks her blood sugar.
  d. Changes the battery in her glucometer.

Question 2

An older man who is right-handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery.
 
  Which is the most important goal for the plan of care to help this man achieve his optimal state of health and wellness? a. Maintain skin integrity of right arm.
  b. Collaborate with occupational therapy (OT).
  c. Promote plaque-reversing strategies.
  d. Support effective coping mechanisms.

[briseldagonzales]

Answer to Question 1

A
An older adult thinks and acts about diabetes mellitus in the foreground perspective when signs of disease progression occur, which is evidenced by the need for the amputation of two toes, be-cause hyperglycemia damaged the lining of vessels and led to peripheral artery disease. The per-fusion to this woman's toes deteriorated to the extent that the tissue died; the dead tissue had to be removed to avoid infection.
Living at home indicates she has a functional status that is sufficient to maintain independent living. This woman is able to monitor her blood sugar independently and retains enough func-tional ability to change a battery.

Answer to Question 2

B
The dominant arm, vital to the skill of a carpenter, is useless to this man unless he can adapt to the impairment with adaptive skills. Collaborating with OT is the most important goal for this older adult because adaptation is the greatest factor in establishing wellness, and OT can assist this man with adaptive tools, skills, and abilities to manage living with a flaccid dominant hand and arm. Maintaining skin integrity should be included in this man's plan of care because a flac-cid extremity is at risk for skin breakdown, but it is not the first priority. Promoting pla-que-reversing strategies, including diet and antilipid medication, should be part of this man's plan of care. However, these strategies are not the most important goal for this man; adaptation is the most important factor in establishing health and wellness. Supporting effective coping me-chanisms is a goal that should be included in this man's plan of care; however, given the flaccid-ity of his dominant arm, the most effective measures toward adaptation are to help him develop the new skills and abilities he will need to cope effectively. Supporting effective coping mechan-isms can help enhance the work of OT.