Katherine O'Grady, 89 years old, lived alone in her small, ...

[mspears3]

Katherine O'Grady, 89 years old, lived alone in her small, two-bedroom home until her cerebrovascular accident (CVA) 2 weeks ago. She had been very independent and required assistance only with transportation to shop, bank, and get to appointments.
 
  She has multiple bruises on her dependent arm from bumping it on walls, furniture, and her wheelchair. One of her diagnoses states unilateral neglect. What is the cause of unilateral neglect?
  a. Left hemisphere CVA
  b. Brainstem involvement
  c. Loss of visual fields related to the CVA
  d. Total loss of movement or sensations

Question 2

Harold Dannon, 68 years old, had his blood pressure checked at the senior citizen center, and the nurse sent him to the physician because his blood pressure was 207/110 mm Hg. When you question Mr.
 
  Dannon about his dosage of Calan SR, he states that he quit taking it because he was too constipated. What is your best response?
  a. Mr. Dannon, you know that you have to take your blood pressure medicine no matter how you feel. You could have had a stroke in the middle of the senior center
  b. Constipation is a problem with that medication. What did you try to help relieve the constipation while you were taking Calan?
  c. There are many different kinds of blood pressure medicines. You could have just called the office, and we would have called in a prescription for something else
  d. I told you that you could get a little consti-pated. You can't quit taking a blood pressure medication without first telling the doctor

[honnalora]

Answer to Question 1

C
The visual field losses of homonymous and bitemporal hemianopsia can result in an older person being unaware of personal and environmental things that are out of his or her visual field. Responses A, B, and D are incorrect. Hemianopsia is not specific to any type or location of a CVA and is not caused by a total loss of movement or sensation.

Answer to Question 2

B
Response B is the best answer because, by discussing the constipation, you can explore Mr. Dannon's learning needs and teach him about managing constipation, which was a serious problem for him. Responses A, C, and D express concern about Mr. Dannon's need to take a blood pressure medication, but they do not open the conversation to promote meeting Mr. Dannon's obvious learning need regarding use of antihypertensives and management of potential side effects.

[mspears3]

TY

[honnalora]

Happy to Help