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(Solution) vSim - Millie Larsen 1/2/3 Latest Spring 2022.
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vSim - Millie Larsen Quizzes 1/2/3With which of the following atypical manifestations of a urinary tract infection might the older
adult present? (Select all that apply.)
a) Weakness
b) Severe nocturnal headache
c) Decreased appetite
d) Alteration in cognitive function
e) Incontinence - a) Weakness
c) Decreased appetite
d) Alteration in cognitive function
e) Incontinence
Infections in the older adult may not manifest in the same way as in a younger adult. Fever, a
typical presenting sign, can be undetected in the older adult. The older adult may present with
weakness, anorexia, changes in mental status, and incontinence. Severe nocturnal headache is not
a manifestation of a urinary tract infection.
Which nursing intervention should the nurse undertake initially to help the patient achieve partial
restoration of bladder control?
a) Provide a bedside commode when appropriate.
b) Offer the patient frequent toileting cues.
c) Ensure easy access to bathroom.
d) Assess voiding patterns. - d) Assess voiding patterns.
The older adult with incontinence may be able to achieve partial restoration of bladder control
through nursing interventions. The initial step should be to conduct a comprehensive assessment
to identify the cause of the incontinence, the potential for regained bladder control, and the
patient's needs. Ensuring that the bathroom is easily accessible and providing the availability of a
bedside commode of bedpan are also appropriate interventions to consider after completing an
initial assessment. Offering the patient cues to consider toileting, including assistance, may also
be appropriate but not implementable until the assessment is completed.
Which assessment finding is an age-related change in the urinary tact?
a) Increased urinary tract infections
b) Increased frequency of urination
c) Decreased protein in the urine
,d) Decreased amounts of glucose in voided urine - b) Increased frequency of urination
Age-related changes in the urinary system include hypertrophy and thickening of the bladder
muscle, decreasing its ability to expand and reducing its storage capacity resulting in an increase
in the frequency of urination. Aging typically causes the renal threshold for glucose to increase.
Aging does not typically result in a decreased risk for urinary infections. There should not be any
protein in the urine.
Which of the following should be included in a teaching plan for a patient with an increased risk
for developing a urinary tract infection?
a) Hydrate with clear liquids only.
b) Reduce fluid intake during daylight hours to 10 to 20 oz.
c) Drink cranberry juice daily.
d) Establish a 6- to 8-hour voiding schedule during the daytime. - c) Drink cranberry juice daily
Medical research supports that regularly drinking cranberry juice is a means to reduce the risk of
urinary tract infections. Restricting fluid intake is not advisable, and drinking only clear liquids is
not necessary. The risk for urinary infection increases when the urine is allowed to stagnate in
the bladder, so bladder emptying should occur more frequently than every 6 to 8 hours.
Which value should the nurse consider abnormal when reviewing a patient's routine urinalysis
report?
a) Urine pH of 3.0
b) Absence of glucose
c) Urine specific gravity of 1.003
d) Absence of protein - a) Urine pH of 3.0
The pH of urine should be between 4.6 and 8.0. Urine specific gravity compares the density of
urine to the density of water. Urine specific gravity in an adult should be 1.000 to 1.030, which
means that the kidneys are functioning at a normal level. Absence of both protein and glucose in
urine is appropriate.
What is the nurse's initial assessment focus for an older patient being admitted for acute
confusion?
a) Serum blood alcohol to rule out intoxication
b) Blood pressure to rule out hypotension
c) Hemoglobin and hematocrit to rule out hemorrhage
, d) Fluid and electrolyte status to rule out dehydration - d) Fluid and electrolyte status to rule out
dehydration
Older adults are at risk for dehydration because aging can cause a decreased sense of thirst and
an increase in urinary frequency. Confusion is a common sign of dehydration among older
patients. Although hypotension, hemorrhage, and alcohol intoxication may all result in various
degrees of confusion, they are not considered primary causes.
An older patient newly diagnosed with hypertension has been prescribed an antihypertensive
medication therapy. The nurse will include which recommendation when providing the patient
with medication education to reduce the risk of falling?
a) Eat a diet high in protein.
b) Get up slowly from a supine position.
c) Keep fluid intake to at least 1,500 mL/day.
d) Avoid exercise that increases heart rate. - b) Get up slowly from a supine position.
Postural hypotension is common in the older adult who is taking antihypertensive medication.
When the individual stands up too quickly after lying down, postural hypotension can cause
dizziness, which is a risk factor for falls. Older adults should be encouraged to exercise with the
anticipated rise in heart rate within the limits of their disease processes; eating a diet high in
protein is not relevant to postural hypotension related to antihypertensive medications. Although
the older adult should drink 1,500 mL of fluids daily to prevent dehydration, this response is not
relevant to the use of antihypertensive medications and postural hypotension.
Which blood pressure component is considered hypertensive in the older adult? (Select all that
apply.)
a) 92 mmHg diastolic
b) 144 mmHg systolic
c) 140 mmHg systolic
d) 88 mmHg diastolic
e) 90 mmHg diastolic - a) 92 mmHg diastolic
b) 144 mmHg systolic
When blood pressure enters a level of less than 140 mmHg systolic and/or less than 90 mmHg
diastolic, it is considered hypertensive.
Millie Larsen states that lately she tries to avoid laughing because of urine leakage. Which type
of incontinence does this finding indicate?
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