Which of the following statements is true about analgesic medications for older adults?

Answer to #1

B
Opioids often cause constipation and necessitate bowel stimulation to prevent constipation. A bowel regimen should be instituted at the same time as opioid treatment. Because of changes in metabolism with aging, opioids have a greater and longer-lasting analgesic effect in older patients. NSAIDs can cause gastrointestinal bleeding, kidney and liver damage, and drug interactions with potentially fatal results. The maximum daily dose of acetaminophen is 4000 mg, and the limit is lower for patients with kidney or liver failure and patients who use alcohol. A typical dose is two 500-mg (extra-strength) tablets.

Answer to #2

B
The nurse conducts individual interviews with the women to determine their interests and to avoid generalizing; as people live longer, they become more and more unique.
Because most of these women are in their 80s, were born between 1920 and 1930, and have generally spent their lives as homemakers, the nurse presumes to know what activities they will enjoy. The nurse avoids arranging group activities until individual interests are determined. In addition, the nurse must assess for allergies and individual fears of animals before exposing an older adult to a pet visit. Unless it is organized on a voluntary basis, the nurse avoids arranging visits by guest speakers. In addition, the nurse will assess each older woman before an outside visit to avoid embarrassing events including incontinence and hearing and vision problems.

Answer to #3

C

Feedback
A Incorrect. The purpose of rehabilitation is to enable the person to regain function but not necessarily specific abilities; this can involve the development of com-pensating abilities (e.g., motorized chair driving) rather than recovery of original abilities (e.g., walking).
B Incorrect. Rehabilitation involves activities involving the entire day, not merely those within an allotted time period.
C Correct. A patient with a severe stroke, for example, may not be able to walk again but may recover mobility by learning to drive a motorized wheelchair.
D Incorrect. On admission, the patient is in crisis and his or her actual abilities may not be evident.

Answer to #4

C
The nurse meets with the older adult to determine how and when to establish new relationships and social activities in light of his wife's death. Although the older man was engaged in fishing before, the nurse respects his wishes and needs as he transitions to a different life.
The nurse avoids confronting him, even if done so in a gentle manner. Why questions can be interpreted as confrontational, and the older adult may be unable or unwilling to articulate a reason. The nurse avoids asking club members to visit him because doing so would remove the older adult from the decision making process. Although this effort can be well-meaning, it can also be interpreted as an invasion of privacy. The older adult is more likely to participate in an activity in which he has input. In addition, the nurse's action can be interpreted as disrespectful because an adult has the right to control his own life.

Answer to #5

C
Morphine sulfate (Morphine), oxycodone (Oxycontin), hydrocodone (Hycodan), hydromorphone (Dilaudid), and fentanyl (Sublimaze) are opioids that can be safely used with older patients. Me-peridine and pentazocine are both contraindicated for older adults because their metabolites can produce confusion, psychotic behavior, and seizures. Used properly, opioids have a lower risk of certain side effects than nonsteroidal antiinflammatory agents (NSAIDs).

Answer to #6

A
Holistic nursing integrates all aspects of an individual's life into the plan of care by balancing an individual's internal and external environment with psychosocial, spiritual, cultural, and physical processes.
Healthy People 2020, an updated document from 2000 that outlines the goals for achieving health in this country, is a mandate for health care professionals to follow with 467 objectives in 28 focus areas. Maslow's Hierarchy of Human Needs provides a basis for understanding indi-viduals in context and for ranking nursing assessments, diagnoses, goals, and interventions in order of importance. Dorothea Orem's Self-Care Requirements lists human needs, including the need for air, fluids, nutrition, hygiene, elimination, activity, comfort, relief from suffering, and skin integrity. The nurse helps individuals meet these needs to achieve optimal health and well-ness.

Answer to #7

B

Feedback
A Incorrect. Chronic illnesses are long-term problems, and cures are not usually available.
B Correct. A chronic illness cannot be cured, but with caring, the nurse can assist the patient to live without being dominated by the demands of the illness.
C Incorrect. If a patient has an incurable illness, the nurse provides a caring envi-ronment to facilitate implementation of the patient's and family's wishes.
D Incorrect. The nurse can help the patient and family to formulate cost-cutting measures if so requested; however, because the nurse is the patient's advocate, the nurse avoids making recommendations about not using services.

This helps so much, thank you for responding so quickly...

No worries, I was online and bored