The nurse is caring for an older adult patient who was admitted with a stage 3 pressure ulcer on the left heel and who also has a history of Parkinson disease and chronic renal failure
To mi-nimize the patient's risk of developing an iatrogenic illness, the nurse:
a. uses sterile technique when changing the heel's dressings.
b. reviews all the patient's medications for possible adverse reactions.
c. instructs the patient to call for assistance when needing to go to the bathroom.
d. assists the patient in choosing the appro-priate foods from the daily menu.
B
Adverse drug reactions frequently precipitate hospitalizations and, although often unreported, are among the most common iatrogenic events in the acute care setting. The hospital staff needs to get an accurate drug history of a patient, be aware of pharmacokinetic and pharmacodynamic changes related to aging, and have a working understanding of drug-disease, drug-drug, and drug-food interactions in older adults. Nurses should be particularly aware of drugs that may be high risk when used in older adults. The other actions are important for patient safety, but the more frequent cause of iatrogenic problems is related to medication use.
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A nursing supervisor is seeking staff input while developing policies regarding violence prevention. A staff nurse says, "We have lots of threatening behaviors on our unit." What is the most important question for the supervisor to ask?
1. "Why is so much threatening behavior happening on your unit?" 2. "Why haven't you reported that?" 3. "Where do you work?" 4. "When you report threats to your manager, is action taken quickly?"
A patient has been admitted to the surgical unit from postanesthetic recovery and begun on a morphine patient-controlled analgesic (PCA) pump. What teaching point should the nurse who is performing this action provide to the patient?
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A pregnant client at 16 weeks' gestation has a hematocrit of 35%. Her prepregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?
1. "Because of your pregnancy, you're not making enough red blood cells." 2. Because your blood volume has increased, your hematocrit count is lower." 3. This change could indicate a serious problem that might harm your baby." 4. "You're not eating enough iron-rich foods like meat."
Mr. Akins is a 78-year-old patient who presents to the clinic with complaints of hearing loss. Which of the following are changes in hearing that occur in older adults? (Select all that apply.)
a. Results from cranial nerve VII b. Slow progression c. Loss of high frequency d. Bone conduction heard longer than air conduction e. Sounds may be garbled, difficult to local-ize f. Unable to hear in a crowded room