The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

Show expected changes in white blood cell counts.

Skin tests for tuberculosis may be falsely negative.

Should receive influenza, pneumococcal, and shingles vaccinations.

Higher risk for respiratory tract and genitourinary infections.

Booster vaccinations are not likely needed as one ages.

May not have a fever with severe infection.

Answer and Explanation

Correct Answer : B,C,D,F

A.   Aging can lead to changes in immune function, including alterations in white blood cell counts. While absolute counts may not be drastically lower, the immune response may be less effective. This is important information as it helps the patient understand their altered immune status and potential infection risks.
B.   Older adults may have a diminished immune response, which can lead to false-negative results in tuberculosis skin tests (e.g., PPD test). This is crucial information, as it can affect diagnosis and treatment decisions, highlighting the need for alternative screening methods.
C.   Vaccinations are critical for older adults to help prevent infections. Influenza, pneumococcal, and shingles vaccines can significantly reduce the risk of these infections, which are more severe in the elderly. This is an essential component of their health maintenance.
D.   Older adults are at increased risk for respiratory tract infections (like pneumonia) and genitourinary infections (like urinary tract infections) due to factors such as comorbidities and changes in immune function. Educating clients about these risks helps them recognize symptoms and seek timely care.
E.   Older adults often require booster vaccinations to maintain immunity, as their immune response may diminish over time. This misinformation could lead to increased susceptibility to vaccine-preventable diseases.
F.   It is common for elderly individuals to present with atypical signs of infection, including the absence of fever even in severe cases. This is important for both the patient and caregivers to understand, as it may lead to delayed recognition and treatment of infections.

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Correct Answer is D

Explanation

A. Oxygen therapy may be indicated if the patient shows signs of respiratory distress or has low oxygen saturation levels, but it does not address the underlying pain or dehydration associated with the crisis.
B. Blood transfusions can be an effective treatment for severe complications of sickle cell disease, including acute chest syndrome or severe anemia. However, transfusions are not typically the immediate priority in the early management of a sickle cell crisis unless there is a clear indication of severe anemia or complications.
C. IV fluid therapy is crucial for managing dehydration, which can exacerbate sickle cell crises. Adequate hydration helps reduce blood viscosity and can alleviate some symptoms. However, while important, fluid therapy alone does not address the immediate and often severe pain that patients experience.
D. Pain management is the top priority in the management of a patient in a sickle cell crisis. Patients often experience severe pain due to vaso-occlusive events, and addressing pain is essential for patient comfort and quality of care.

A. Perform a sputum culture B. Instruct the patient to obtain yearly influenza vaccination C. Administer oxygen therapy D. Administer antibiotics

Correct Answer is C

Explanation

A. While obtaining a sputum culture is important for identifying the causative organism and guiding antibiotic therapy, it is not an immediate priority. Delaying this test briefly for critical interventions (like oxygen administration) is acceptable, as stabilizing the patient's oxygen levels is more urgent.
B. Educating the patient about vaccination is important for long-term health and prevention of future respiratory infections. However, it does not address the current situation and does not provide immediate benefit for the acute episode of pneumonia.
C. The patient has a SpO2 of 91%, which indicates hypoxemia (low oxygen levels in the blood). In pneumonia, adequate oxygenation is crucial to prevent further respiratory distress and potential complications. Administering oxygen therapy will help improve the oxygen saturation and support the patient’s respiratory function, making this the highest priority intervention.
D. While antibiotics are essential for treating bacterial pneumonia, they may take time to exert their effects. In this acute scenario, the immediate need is to ensure the patient is adequately oxygenated. After oxygen is administered, antibiotics can be given promptly.

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The nurse is teaching an elderly client the risks of infection for older adults. Which of the following factors would the nurse include in the education? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse admits a patient who is in a sickle cell crisis. The nurse should prepare for which intervention as the top priority in the management of the patient?

Correct Answer is D

Explanation

A nurse is caring for a client who has pneumonia. Assessment findings include T 100.4 deg F, RR 30, BP 130/76, HR 100, and SpO2 91% on room air. Which of the following is the PRIORITY intervention?

Correct Answer is C

Explanation

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