Exam (elaborations)
Gerontological Nursing, 4e (Tabloski) Chapter 16 The Respiratory System
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Gerontological Nursing, 4e (Tabloski) Chapter 16 The Respiratory System
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Gerontological Nursing, 4e (Tabloski)Chapter 16 The Respiratory System
1) Whichrrespiratoryrsystemrassessmentrfindingrofranrolderrclientrdoesrthernurserdeterminerisrmo
strconcerning?
1. Coughingrduringrthernightrwhilersleeping
2. Purposefullyrsittingruprstraighterrtorgetrardeeprbreath
3. Shortnessrofrbreathrwhenrcrossingrarlargerparkingrlot
4. ThreerepisodesrofrdiagnosedrbronchitisrinrtwelvermonthsrA
nswer:r 1
Explanation:r1.rCoughingrduringrsleeprcanrberarsignrofrasthma,rheartrfailure,rorrotherrcondition,rbutrit
risrnotrnormalrandrmustrberinvestigated.
2. Decreasedrmusclertone,rincreasedrabdominalrgirth,rthoracicrrigidity,randrotherrissuesrcanrleadrtori
ncompleterchestrexpansion.rTherclientrwhorisrawarerofrthisrmayrpurposefullyrsitruprstraighterrtortaker
ardeeperrbreath.
3. Thererisranrincreaserinrstiffnessrofrtherchestrwall,rdecreasedrvitalrcapacity,randrincreasedrresidualrv
olumeroccurrwithraging.rWalkingrarsignificantrdistancercanrresultrinrshortnessrofrbreath.rIfrtherclientr
becomesrshortrofrbreathrwhenrwalkingrinrtherhouse,rthatrisrcauserforrconcern.
4. Immunerchangesrcanrcauserincreasedrfrequencyrofrrespiratoryrinfections.rIfrinfectionsroccurrmo
rercloselyrtogetherrorrtherclientrjustrneverrseemsrtorgetrwell,rthisrisrcauserforrincreasedrconcern.
PagerRef:r385-
390rCognitiverLevel:r Analy
zing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rAssessment
LearningrOutcome:rr1.rDefinernormalrchangesrofragingrofrtherrespiratoryrsystem.
1
Copyrightr©r2019rPearsonrEducation,rInc.
,2) Thernurserplansrteachingrforrtherolderradultrclientraboutrpreventionrofrrespiratoryrillnesses.rWh
atrisrthermostrimportantrstrategyrforrtherclientrtoruse?
1. Obtainrvaccinationsrasrscheduled
2. Reduceruserofrinhaledrtobacco
3. Wearrarmaskrwhenrmowingrtherlawn
4. Userhandrsanitizerrafterrshoppingr
Answer:r 1
Explanation:r 1.rGettingrarflurvaccinationrannuallyrandrpneumoniarvaccinationrbeginningratrtherage
rofr65rarerkeyrtorkeepingrtherimmunersystemrhealthyragainstrdiseases.rFlurandrpneumoniarcanrresul
trinrdeathrinrtherolderradultrclient.
2. Eliminationrofrsmokingrisrrecommended.rThisrincludesrallrsmokingrincludingrtobacco,rel
ectronicrcigarettes,randrotherrinhaled,rrecreationalrsubstances.
3. Ifrtherclientrisrallergicrtorsubstancesrfoundrinrtherlawn,rthenrthisrisradvisable.rTherclientrshouldravoi
drallergens.rairbornertoxins,randrairrpollution.rThisrisrnotrarnecessaryrprecautionrforrmanyradults.
4. Washingrhandsrfrequentlyrandravoidingrothersrwhorarersickrisrideal.rWhilershopping,rtherclientrm
ayrhavercomerintorcontactrwithrmanyrinfectiousrsources.rWhilerusingrhandrsanitizerrafterrthertriprisrgo
od,rdependingronrthertimerofryear,rthisrmayrnotrberarstrictrenoughrstrategyrtorpreventrinfection.
PagerRef:r387
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rPlanning
LearningrOutcome:rr1.rDefinernormalrchangesrofragingrofrtherrespiratoryrsystem.
2
Copyrightr©r2019rPearsonrEducation,rInc.
, 3) Anrolderrclientrisrscheduledrforrdiagnosticrtesting.rWhatrisrtherbestrindicationrforrtherclientrtorund
ergorpulmonaryrfunctionrtests?
1. Chestrx-rayrdemonstratingrbilateralrinfiltrates
2. Abnormalrarterialrbloodrgasranalysisrresults
3. Therpresencerofrhemoptysisrandrfatigue
4. Chronicrwheezingrwithranrundiagnosedrcauser
Answer:r 4
Explanation:r 1.rArchestrx-
rayrwillrgiverinformationrrelatedrtortherpulmonaryrcondition.rInfiltratesroftenrindicaterpneumoniarorr
similarrprocess.rIfrthisrinformationrisrnotrspecificrenough,rarCTrscanrisrthernextrdiagnosticrtestrthernur
seranticipates.
2. AnrabnormalrABGrisrtreatedrwithrmedicationsrorrventilationrassistance.rFurtherrtestingrisrnotrwar
rantedruntilrtherimbalancerisrcorrected.
3. Hemoptysisrandrfatiguerarerindicationsrforrarbatteryrofrrespiratoryrtests,rincludingrCTrorrPETrsca
nrorrbronchoscopy.rArpulmonaryrfunctionrtestrmayrberincluded,rbutritrisrnotrtherbestrindicationrforrt
hisrtest.
4. Pulmonaryrfunctionrtestsrarerthermostrreliablerwayrtordiagnoserasthmarandrdifferentiateritrfromrot
herrillnessrsuchrasrCOPD.rMeasurementrofrairrduringrexpirationrisrusedrinrtherdifferentialrdiagnosis.
PagerRef:r413
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNur
s/IntegrConc.:r NursingrProcess:rPlanning
LearningrOutcome:r3.rDiscussrthernurse'srrolerinrcaringrforrolderradultsrwithrrespiratoryrproblems.
3
Copyrightr©r2019rPearsonrEducation,rInc.
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