A nurse is assessing a client who is 75 years old. Which of the following findings is most likely related to the decreased contractile strength of the myocardium in older adults?

The correct answer is A.

“I need to eat more foods that are rich in these nutrients.” This statement indicates that the client understands that low levels of iron, calcium and vitamin B12 can be caused by inadequate dietary intake of these nutrients.Iron, calcium and vitamin B12 are mainly found in animal-based foods, such as meat, eggs, milk and cheese.A diet lacking in these foods can lead to vitamin deficiency anemia, which is a condition where the body produces fewer and larger red blood cells that cannot carry enough oxygen.

Choice B is wrong because supplements may not be necessary or sufficient to correct these deficiencies.

Supplements can also interact with other medications or have side effects.The client should consult with their healthcare provider before taking any supplements.

Choice C is wrong because gastric acid inhibitors can actually worsen vitamin B12 deficiency.

Gastric acid inhibitors are medications that reduce the amount of stomach acid produced.However, stomach acid is needed to release vitamin B12 from food and to help it bind to a protein called intrinsic factor, which is essential for its absorption in the intestines.

Therefore, taking gastric acid inhibitors can impair vitamin B12 absorption and lead to deficiency.

Choice D is wrong because reducing dairy consumption can further lower calcium intake.

Dairy products are a good source of calcium, which is a mineral that helps build and maintain strong bones and teeth.Calcium deficiency can lead to osteoporosis, which is a condition where the bones become weak and brittle.

Normal ranges for iron, calcium and vitamin B12 in the blood are:.

• Iron: 50 to 170 micrograms per deciliter (mcg/dL) for men; 40 to 150 mcg/dL for women.

• Calcium: 8.5 to 10.2 milligrams per deciliter (mg/dL).

• Vitamin B12: 200 to 900 picograms per milliliter (pg/mL).

The correct answer is B.

Instruct the client to tuck their chin when swallowing.

This action helps to prevent aspiration by closing off the airway and directing food and liquid into the esophagus.It also reduces the risk of food getting stuck in the throat or chest.

Choice A is wrong because thin liquids are more difficult to swallow and control for clients who have dysphagia due to decreased esophageal motility.They can easily enter the airway and cause choking or pneumonia.

Choice C is wrong because hot or spicy foods can irritate the esophagus and worsen the symptoms of dysphagia.They can also trigger reflux, which can damage the esophageal lining and cause narrowing or inflammation.

Choice D is wrong because elevating the head of the bed to 30 degrees during meals is not enough to prevent aspiration or regurgitation.The client should be sitting upright at 90 degrees or higher to facilitate swallowing and gravity.

Normal ranges for esophageal motility are:.

• Lower esophageal sphincter pressure: 10 to 45 mm Hg.

• Peristaltic amplitude: 30 to 180 mm Hg.

• Peristaltic duration: 2.5 to 6 seconds.

• Peristaltic velocity: 2 to 4.5 cm/s.