Author Question: An African-American 58-year-old man in good health has a blood pressure at 120/73 mm Hg at his ... (Read 78 times)

Mr. Wonderful · **on:** Jul 11, 2018

An African-American 58-year-old man in good health has a blood pressure at 120/73 mm Hg at his annual physical examination.

Which of the following is the best goal for the nurse to use to assist him in maintaining his health and wellness into older age? a. Alter modifiable risk factors.
b. Prevent cardiovascular disease.
c. Recognize disease in early stage.
d. Maintain tight glycemic control.

Question 2

Which is a true statement about heart disease in older adults?

a. Myocardial infarction has many of the same symptoms in older patients as in middle-aged persons.
b. Both excessive urination at night and decreased urination can be signs of heart failure.
c. Any exertion on the part of an older adult patient with heart disease can bring on another heart attack.
d. A person with heart failure is likely to have trouble breathing, except when lying down.

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

Answer to Question 1

B
The nurse assists this adult in maintaining health and wellness by helping him prevent cardi-ovascular disease; as an older African-American man, he has a high risk of stroke, hypertension, and diabetes mellitus. Furthermore, he is more likely to die of a stroke or heart attack than other people in the United States. To help him prevent cardiovascular disease, the nurse assists him with lifestyle modifications. Specific recommendations the nurse can make include getting regu-lar exercise; learning the warning signs of heart attack and stroke; maintaining a normal weight; controlling blood pressure; eating a well-balanced, low-fat, no-added-salt diet; and avoiding smoking.
Altering modifiable risk factors is a subgoal to preventing cardiovascular disease. Learn-ing the early warning signs of disease is a subgoal to preventing cardiovascular disease. Although he has no clinical indicators of hyperglycemia, he is at risk for developing diabetes mellitus, which is an important subgoal of preventing cardiovascular disease for an African-American man.

Answer to Question 2

B

Feedback
A Incorrect. In older patients the classic presentation of angina pectoris is often absent in what is known as a silent myocardial infarction (MI), with only mild discomfort, perhaps even limited to nausea or heartburn.
B Correct. Because the heart is an ineffective pump in heart failure (HF), both of these can occur when older adults have an MI. Nocturia occurs in heart failure when the heart is unable to maintain adequate renal blood flow in the perfor-mance of daily activities; then, during the night when the patient's lower ex-tremities are elevated for sleep, the heart is able to perfuse the kidneys with the assistance of increased venous return owing to the elevated extremities. Inade-quate urine production is due to inadequate perfusion from an ineffective pump.
C Incorrect. Failure to engage in cardiac rehabilitation exercise is more likely to result in another MI or aggravation of HF than ordinary exertion.
D Incorrect. A person with HF is more likely to have difficulty breathing except when the trunk is upright (orthopnea).