The nurse plans care to prevent a dangerous thermal environment for an older male adult who lives in a northern climate of the United States. Which patient assessment data does the nurse recognize that can contribute to his risk of hypothermia?

Question

a. Is post–cerebrovascular accident
b. Has a history of diabetes mellitus
c. Builds miniature cars for a hobby
d. Bathes 3 to 4 times a week
e. Gets heat from a boiler in the cellar
f. Becomes diaphoretic on warm days

Answer 1

A, B, C, E

a. Correct. A cerebrovascular accident (CVA) can impair an older adult's thermoregulatory center and potentially diminish the individual's awareness of temperature changes or the ability to respond suitably to a temperature change. In addition, if the older adult is left with a cognitive deficit or aphasia, an older adult's ability to communicate a thermal prob-lem is potentially impaired.
b. Correct. A history of diabetes mellitus can contribute to a dangerous thermal environment for the older adult because a complication of diabetes is peripheral neuropathy, which po-tentially impairs the ability to sense temperature change. In addition, peripheral arterial disease associated with diabetes contributes to the individual's ability to compensate to temperature changes with vasodilation or vasoconstriction.
c. Correct. Building miniature cars is a sedentary activity. The associated metabolic activity is low, the older adult generates less heat from metabolic activity, and the individual is at a higher risk for hypothermia when the temperature is cool.
d. Incorrect. Bathing 3 to 4 times a week limits the exposure of bare skin to the cooling ef-fects of evaporation to reduce the risk of hypothermia.
e. Correct. Household heat from a boiler in the cellar creates a potential regulatory problem for the older adult living in the building because adjustments to temperature affect the en-tire household and are made in the cellar only. Thermostats in individual rooms do not ex-ist in such a heating system. If the individual has impaired mobility, he can be unable to navigate the stairs to the cellar and adjust the temperature.
f. Incorrect. Diaphoresis on a warm day is a suitable response to heat.