Author Question: An older female adult has a wound infection 5 days after a below-the-knee amputation brought about ... (Read 34 times)

skymedlock · **on:** Jul 11, 2018

An older female adult has a wound infection 5 days after a below-the-knee amputation brought about by diabetes mellitus.

Which is the nurse's priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult? a. Remove invasive devices as soon as possible.
b. Minimize administration of opioid analgesics.
c. Allow for self-care and independent activities.
d. Administer short-acting benzodiazepines PRN.

Question 2

The nurse observes older female adults learning advanced knitting techniques. The nurse concludes that this is a suitable learning activity for these women because it accomplishes which of the following?

a. Helps to maintain joint flexibility
b. Improves the group's cohesiveness
c. Provides a needed social opportunity
d. Adds to their existing knowledge base

Ptupou85 · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

A

Feedback
A Correct. To help prevent cognitive dysfunction, postoperative complications, and an increased risk of morbidity and mortality, the nurse recognizes the risk factors this older adult has for delirium including stressors, infection, and surgery; thus, to prevent cognitive decline and additional postoperative complications, the nurse removes invasive devices promptly such as intravenous infusions, urinary catheters, and wound drains. Removing these devices not only reduces the risk of infection, thromboembolic events, blood loss, injury, and fluid imbalance, but they serve to promote mobility, promote a sense of control for the patient, and reduce the types of situations that can frighten the patient or that the patient can misinterpret.
B Incorrect. Poor pain management can contribute to delirium in older patients.
C Incorrect. A patient with multiple stressors and risk factors for delirium needs additional nursing care and attention to provide a calming, caring therapeutic environment. The nurse must assess the patient's functional status before allow-ing self-care and independent activities. In addition, this older adult is likely to need extensive physical therapy to maintain mobility.
D Incorrect. Benzodiazepines are a poor pharmacological choice for older adults for sedation or sleep because they can contribute to delirium, are highly addic-tive, and can cause rebound insomnia if withdrawn suddenly.

Answer to Question 2

D

Feedback
A Incorrect. Joint flexibility is a physical activity and not necessarily a learning activity.
B Incorrect. The members share enjoyment of knitting; other than being female and older, the group has no special bond on which to build.
C Incorrect. The need for socializing is not evident.
D Correct. Learning advanced techniques is a suitable activity for older adults be-cause it builds on knowledge they have already; further, it is suitable because it is concrete and practical for experienced knitters to develop advanced skills.