The overall temperature in your gerontological unit is 62 F ...

[@Brianna17]

The overall temperature in your gerontological unit is 62 F during the evening shift. In documenting this concern to the administration, which factor is the most important for the health and well-being of older adults?
 
  a. It is not fair for older adults to have to deal with an uncomfortable environment.
  b. Some of the residents are wearing blankets around their shoulders to keep warm.
  c. An ambient temperature of 62 F is un-suitable for older people because they have impaired thermoregulation.
  d. It feels much warmer in the administration wing than out in the patient care areas.

Question 2

The nurse prepares to administer vancomycin (Vancocin) to an older adult. Which labor-atory test should the nurse review before administering this medication?
 
  a. Stool culture
  b. Serum potassium
  c. Creatinine clearance
  d. Alkaline phosphatase

[nathang24]

Answer to Question 1

C
Under no circumstances should the temperature drop below 65 F because older adults are at risk for hypothermia. Furthermore, frail older adults need the temperature to be considerably higher. The issue is not one of fairness but a more fundamental issue of patient safety. Some of the resi-dents wearing blankets may represent individual temperature preferences. The purpose is to make the point that the patients are vulnerable to low temperatures, not to make veiled accusations against the administrators.

Answer to Question 2

C

Feedback
A Incorrect. The pathogen is already identified; however, some value can be ob-tained from subsequent stool cultures to determine if the infection is eradicated.
B Incorrect. Serum potassium is a reasonable parameter to check in an older adult; however, if used as a measure of renal function, the creatinine clearance is a better choice.
C Correct. Antibiotics as a group of drugs are hard on the kidneys; thus the nurse should check the creatinine clearance of this individual. Although about 30 of absorbed vancomycin is protein bound, it is cleared by the kidneys, and creati-nine clearance is the best index of renal function available. Because approx-imately 70 of vancomycin circulates in the blood stream in the active form, when the older adult has renal dysfunction, the dosage must be reduced or the dosing intervals increased to maintain the desired drug level and prevent toxici-ty.
D Incorrect. Alkaline phosphatase is a measure of hepatic function. It is a reasona-ble parameter to check when administering medications because hepatic clear-ance is important in the metabolism of many medications.