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Gerontological Nursing, 4e (Tabloski) Chapter 15 The Cardiovascular System
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Gerontological Nursing, 4e (Tabloski) Chapter 15 The Cardiovascular System
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Gerontological Nursing, 4e (Tabloski)Chapter 15 The Cardiovascular System
1) Anrolderrfemalerpatientrexperiencesrfatiguerandrnausea,risrnotrsleepingrwell,randrmakesrarvag
uercomplaintrofrintermittentrchestrdiscomfort.rHowrshouldrthernurserinterpretrthesersymptoms?
1. Signsrofranemia
2. Pancreaticrdisease
3. Myocardialrinfarction
4. Normalrchangesrofragingr
Answer:r 3
Explanation:r 1.rAnemiarwouldrpresentrwithrfatiguerbutrnotrwithrnausearorrchestrdiscomfort.
2. Pancreaticrdiseaserwouldrpresentrwithrpainrinrtherabdominalrregion.
3. Manyrolderrwomenrwillrcomplainrofrvaguersymptomsrwhenrhavingrarmyocardialrinfarction,rinc
ludingrfatigue,rsleeprdisturbances,randrepigastricrpain.
4. Thesersymptomsrarernotrconsideredrnormalrchangesrofraging.rP
agerRef:r370
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r3.rRelaterphysiologicalrconceptsrtortherdiagnosisrandrmanagementrofrcommo
nrcardiovascularrrisksrandrconditions,rincludingrhypertension,rangina,rheartrfailure,randrperipheralr
vascularrdisease.
2) Duringrarbloodrpressurerscreeningratrarpharmacy,ranrolderrpersonrexperiencesrarflutteringrinrther
chest.rWhatrshouldrthernurserinterpretrthisrfindingrasrbeing?
1. Hypothyroidism
2. Exerciserintolerance
3. Nonspecificrcardiacrchangesrwithraging
4. Underlyingrillnessrthatrrequiresrarmedicalrevaluationr
Answer:r 4
Explanation:r 1.rChestrflutteringrcanrberarsignrofrhyperthyroidism,rnotrhypothyroidism.
2. Exerciserintolerancerwouldrincludersymptomsrofrshortnessrofrbreath,rwhichrtherolderrpersonrdo
esrnotrreport.
3. Thisrsymptomrdoesrnotrindicaternormalrcardiacrchanges.
4. Newronsetratrialrfibrillationrandrotherrarrhythmiasrmayrsignalrtheronsetrofrarseriousrunderlyingrilln
essrthatrrequiresrfurtherrmedicalrevaluation.
PagerRef:r370
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r3.rRelaterphysiologicalrconceptsrtortherdiagnosisrandrmanagementrofrcommo
nrcardiovascularrrisksrandrconditions,rincludingrhypertension,rangina,rheartrfailure,randrperipheralr
vascularrdisease.
1
Copyrightr©r2019rPearsonrEducation,rInc.
,3) Anrolderrpatientrhasrarbloodrpressurerreadingrofr150/88.rTherpatientrreportsrnorotherrsym
ptomsrorrmedicalrhistoryrofrillness.rWhatrshouldrthernurserinstructrtherpatientrtordo?
1. Havertherbloodrpressurerrecheckedrinrarmonth.
2. Dornothingrsincerthisrisrarnormalrvariantrofraging.
3. Gortortheremergencyrdepartmentrforrfurtherrevaluationrandrtreatment.
4. Contactrtherprimaryrcarerproviderrforrfurtherrevaluationrandrtreatment.rA
nswer:r 4
Explanation:r 1.rWaitingrforr1rmonthrtorrecheckrtherbloodrpressurerisrtoorlongrofrarperiodrofrtimerforre
valuationrandrtreatment.
2. Bloodrpressurerelevationrfrequentlyroccursrwithraging,ralthoughritrisrnotrconsideredrarnormalrvar
iant.
3. Itrisrnotrarsymptomrofremergentrnaturerbecausertherdiastolicrisrnotrelevatedrabover110rmmrHg.
4. Ifrleftruncontrolled,rhighrsystolicrpressurercanrleadrtorstroke,rmyocardialrinfarction,rheartrfailur
e,rkidneyrdamage,rblindness,rorrotherrconditions.rAlthoughritrcannotrbercuredronceritrhasrdevelope
d,risolatedrsystolicrhypertensionr(ISH)rcanrbercontrolled.
PagerRef:r371
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:r3.rRelaterphysiologicalrconceptsrtortherdiagnosisrandrmanagementrofrcommo
nrcardiovascularrrisksrandrconditions,rincludingrhypertension,rangina,rheartrfailure,randrperipheralr
vascularrdisease.
4) Duringrarhomervisit,rthernurserlearnsrthatranrolderrpatientrwithrhypertensionrtakesrprescribedrme
dicationsronlyrwhenrfeelingrtense.rWhatrinstructionrshouldrthernurserprovidertortherpatient?
1. Contactrtherphysicianrforrarchangerinrbloodrpressurermedication.
2. Continuertoradministerrtherbloodrpressurermedicationrasrneeded.
3. Teachrtortakertherbloodrpressurermedicationrasrprescribedrregardlessrofrfeelingrtense.
4. Instructrtortakerardoublerdoserofrthermedicationrforronerdayrthenrresumerthernormalrschedule.rAns
wer:r 3
Explanation:r 1.rTherdosagerprescribedrmayrberappropriaterifrtakenrdaily;rtherefore,ritrwouldrnotrnee
drtorberchanged.
2. Therpatient'srcurrentrpracticerisrincorrect.rTherpatientrneedsrtorberinstructedrtortakertherme
dicationrasrprescribedrandrnotronlyrwhenrfeelingrtense.
3. Patientsrsometimesrmistakenlyrtakerbloodrpressurermedicationronlyronranras-
neededrbasis.rThisrisrincorrectrandrtherpatientrshouldrtakerthermedicationrasrprescribedronrardailyr
basis.
4. Toradvisertherpatientrtorincreaserthermedicationrwithoutrarphysicianrconsultationrwouldrberoutrofrt
herscoperofrnursingrpractice.
PagerRef:r372-
376rCognitiverLevel:r Appl
ying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNurs/Int
egrConc.:r NursingrProcess:rImplementation
LearningrOutcome:r 5.rIdentifyrspecificrnursingrinterventionsrusedrwithrcardiovascularrpatients.
2
Copyrightr©r2019rPearsonrEducation,rInc.
, 5) Thernurserisrplanningrcarerforranrolderrpatientrwithrhypertensionrwhorrecentlyrfellrinrtherho
me.rWhichrassessmentrwouldrthernurserplanrforrthisrpatient?
1. Checkrserumrsodiumrlevels.
2. Checkrserumrcreatininerlevels.
3. Checkrposturalrbloodrpressures.
4. Checkrbloodrpressurereveryr2rhours.r
Answer:r 3
Explanation:r 1.rSerumrsodiumrlevelsrwouldrberusedrtorassessrrenalrfunction.
2. Serumrcreatininerlevelsrwouldrberusedrtorassessrrenalrfunction.
3. Sincerbaroreceptorsrarerlessrefficientrwithraging,rposturalrhypotensionrisrmorerlikelyrtoroccur.rAls
o,rpatientsrtreatedrforrhypertensionrcouldrhaveranrincreaserinrsensitivityrtorthermedications.rPostural
rbloodrpressurerassessmentrallowsrthernursertorpreventrposturalrhypotensionrandrfalls.
4. Everyr2rhoursrisrtoorfrequentrforrassessmentsrofrarnoncriticalrpatient.rCo
gnitiverLevel:rrApplying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNu
rs/IntegrConc.:r NursingrProcess:rPlanning
LearningrOutcome:r 5.rIdentifyrspecificrnursingrinterventionsrusedrwithrcardiovascularrpatients.
6) Thernurserisrplanningrarpresentationrtorargrouprofrseniorrcitizensronrlifestylermodificationsrtorman
agerhighrbloodrpressure.rWhatrmajorrpointsrwillrthernurserincluderinrthisrpresentation?rSelectrallrtha
trapply.
1. Keeprsodiumrintakertor2.4rgramsrperrday.
2. Achieverandrmaintainrarnormalrbodyrmassrindex.
3. Performraerobicractivityrforr30rminutesrmostrdaysrofrtherweek.
4. Consumptionrofrfruitsrandrwholergrainsrhasrlittlerimpactronrbloodrpressure.
5. Limitrdailyralcoholrintakertortwordrinksrforrmalesrandronerdrinkrforrfemales.rAn
swer:r 1,r2,r3,r5
Explanation:r 1.rOnerlifestylermodificationrisrtorkeeprsodiumrintakerbelowr2.4rgramsrperrday.
2. Onerlifestylermodificationrisrtorachieverandrmaintainrarnormalrbodyrmassrindex.
3. Onerlifestylermodificationrisrtorperformraerobicractivityrforr30rminutesrmostrdaysrofrtherweek.
4. Increasingrtherconsumptionrofrfruits,rvegetables,randrwholergrainsrwillrlowerrbloodrpressure.
5. Onerlifestylermodificationrisrtorlimitrdailyralcoholrintakertortwordrinksrforrmalesrandronerdrinkrforrf
emales.
PagerRef:r374
CognitiverLevel:r Applying
ClientrNeed:r HealthrPromotionrandrMaintenancer
Nurs/IntegrConc.:r NursingrProcess:rPlanning
LearningrOutcome:r 6.rOutlineranreducationrplanrforrcardiovascularrpatients.
3
Copyrightr©r2019rPearsonrEducation,rInc.
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