The nurse is caring for a confused patient. Which action by the nurse shows the best understand-ing of managing the cascading effects of iatrogenic illnesses in this population cohort?
a. Reorienting the patient to person, place, and time frequently
b. Offering the patient liquids each time there is patient-nurse contact
c. Repositioning the patient every 2 hours
d. Using restraints to ensure patient safety only as a last resort
D
Once older adults are hospitalized, immobilization through enforced bed rest or restraint often results in functional disability, and the subsequent occurrence of iatrogenic illnesses often represents a vicious circle, referred to as the cascade effect, in which one problem increases the person's vulnerability to another one. Gerontologic nurses must be leaders in advocating more appropriate care and treatment of hospitalized older adults to prevent or at least reduce the oc-currence of iatrogenic illness. The other actions are good nursing care but do not relate to the cascade effect.
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The patient, age 58, is diagnosed with osteoporosis after densitometry testing
She has been menopausal for 5 years and has been concerned about her risk for osteoporosis because her mother has osteoporosis. In teaching her about her osteoporosis, which information does the nurse include? a. Even with a family history of osteoporosis, the calcium loss from bones can be slowed by increased calcium intake and exercise. b. Estrogen replacement therapy must be started to prevent rapid progression of her osteoporosis. c. With a family history of osteoporosis, there is no way to prevent or slow bone reabsorption. d. Continuous, low-dose corticosteroid treatment is effective in stopping the course of osteoporosis.
The nurse is working on the night shift when she notices sinus bradycardia on the patient's cardiac monitor. The nurse should:
a. give atropine to increase heart rate. b. begin transcutaneous pacing of the patient. c. start a dopamine infusion to stimulate heart function. d. assess for hemodynamic instability.
During an infusion of albumin, the nurse monitors the patient closely for the development of which adverse effect?
a. Hypernatremia b. Fluid volume deficit c. Fluid volume overload d. Transfusion reaction
A 42-year-old woman is seen in the clinic with fever, chills, vomiting, and severe dysuria. She is diagnosed with acute pyelonephritis. How should this patient be managed?
a. 3-day course of oral antibiotics c. Encourage cranberry juice intake b. Hospitalization d. 6-week course of antibiotics