A nurse is performing a mental status examination on an older adult client who has delirium.
Which of the following tools can the nurse use to assess the client’s attention span and concentration?
Mini-Mental State Examination (MMSE).
Confusion Assessment Method (CAM).
Clock Drawing Test (CDT).
Digit Span Test (DST).
The Correct Answer is D
The correct answer is D.
Digit Span Test (DST).
The DST is a tool that can be used to assess the client’s attention span and concentration by asking them to repeat a series of digits forward and backward (Martin, 1990).
The DST is part of the Mini-Mental State Examination (MMSE), which is a broader tool that covers other domains of cognitive functioning, such as orientation, memory, language, and visuospatial skills (Folstein et al., 1975).
Choice A is wrong because the MMSE is not a specific tool for attention span and concentration, but rather a general screening tool for cognitive impairment.
Choice B is wrong because the Confusion Assessment Method (CAM) is a tool that can be used to diagnose delirium, but not to assess attention span and concentration.
The CAM focuses on four features of delirium: acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness (Inouye et al., 1990).
Choice C is wrong because the Clock Drawing Test (CDT) is a tool that can be used to assess visuospatial skills and executive function, but not attention span and concentration.
The CDT requires the client to draw a clock face with numbers and hands indicating a specific time (Shulman et al., 1986).
Normal ranges for the DST vary depending on the age and education level of the client, but generally a score of 5 or more digits forward and 4 or more digits backward is considered normal (Martin, 1990).
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Correct Answer is D
Explanation
You can do any of the above options, depending on your preference and medical condition.
Erectile dysfunction (ED) is the inability to get and maintain an erection for sexual activity.
It can be caused by physical or psychological factors, or both.
ED can affect your self-esteem, stress level and relationship quality.
There are different treatment options for ED, and they work in different ways.
Some of the most common ones are:.
• Oral medicationssuch as sildenafil (Viagra), tadalafil (Cialis), vardenafil (Levitra) or avanafil (Stendra).
These drugs enhance the effects of nitric oxide, a chemical that relaxes the muscles in the penis and increases blood flow.
You need to take them before sexual activity, and they only work if you are sexually stimulated.
They are not safe for everyone, especially if you have heart problems, low blood pressure, liver disease or certain eye conditions.They can also cause side effects such as headache, flushing, nasal congestion or indigestion.
• Penile self-injectionssuch as alprostadil (Caverject, Edex) or papaverine (OraVerse).
These are shots of medicine that you inject into the base or side of your penis with a fine needle.
They cause an erection by dilating the blood vessels in the penis.
The erection lasts about 20 to 30 minutes, and you need to use them only when needed.They can cause side effects such as bleeding, pain, priapism (a prolonged and painful erection) or fibrous tissue formation.
• Alprostadil urethral suppository(Muse).
This is a tiny pellet of medicine that you insert into your urethra (the tube that carries urine out of the body) with a special device.
It works by expanding the blood vessels in the penis and causing an erection.
The erection lasts about 30 to 60 minutes, and you need to use it only when needed.It can cause side effects such as burning, pain, bleeding or infection.
• Vacuum erection device(VED).
This is a plastic tube that you place over your penis and pump out the air to create a vacuum.
This draws blood into the penis and causes an erection.
You then slide a rubber ring around the base of your penis to keep the blood in place.
The erection lasts as long as the ring is on, up to 30 minutes.
You need to use it only when needed.It can cause side effects such as bruising, numbness, pain or difficulty ejaculating.
• Penile implant surgery.
This is a procedure where inflatable or bendable devices are surgically placed on both sides of your penis.
You can control when and how long you have an erection by inflating or deflating the devices with a pump or a switch.This is a permanent solution for ED, but it requires surgery and has risks of infection, mechanical failure or erosion.
Other treatment options for ED include hormone therapy, psychotherapy, lifestyle changes and natural remedies.
However, these may not be as effective or safe as the ones mentioned above.
The best treatment option for you depends on your personal preference, medical condition, cost and availability.
You should talk to your doctor about the benefits and risks of each option and choose the one that suits you best.
Correct Answer is D
Explanation
The correct answer isD.
All of the above.
The nurse should take all of the actions listed to provide effective pain management for the older adult client who has depression and chronic pain in his lower back.
• Choice Ais correct because assessing the pain using a valid and reliable pain scale is essential for determining the severity and impact of pain, as well as monitoring the response to treatment.
• Choice Bis correct because administering analgesic medications as prescribed can help reduce pain and improve function.
The nurse should also monitor for effectiveness and side effects, especially in older adults who may have altered drug metabolism, polypharmacy, and increased risk of adverse events.
• Choice Cis correct because providing non-pharmacological interventions can enhance pain relief, reduce medication use, and address the biopsychosocial aspects of pain.
Massage, heat or cold therapy, relaxation techniques, and distraction are some examples of non-pharmacological interventions that can be used for chronic pain in older adults.
• Choice Dis correct because it includes all of the above actions, which are part of a multimodal approach to pain management that is recommended by clinical guidelines.
4 7 A multimodal approach can improve pain outcomes, reduce side effects, and address the complex needs of older adults with chronic pain.
A. Assess the location, intensity, quality and duration of the pain using a pain scale B.
Administer analgesic medications as prescribed and monitor for effectiveness and side effects C.
Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction D.
All of the above
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