The nurse provides care for an older adult client diagnosed with aspiration pneumonia as a complication of dysphagia. Which statement best explains the increased risk of infection in the older adult population?

Choice A reason: Lymph structures were removed and fluid cannot move out of the area easily is the correct explanation because a radical mastectomy involves the removal of the breast, the underlying chest muscles, and the lymph nodes in the axilla. The lymph nodes are part of the lymphatic system, which is responsible for draining excess fluid from the tissues and returning it to the bloodstream. When the lymph nodes are removed, the fluid cannot be drained properly and accumulates in the affected arm and hand, causing edema.

Choice B reason: There is still too much swelling in the area of the surgery and fluid is accumulating is not the correct explanation because it does not address the underlying cause of the edema. Swelling is a normal response to surgery, but it usually subsides within a few days or weeks. The edema caused by lymph node removal is chronic and persistent, and it does not improve with time.

Choice C reason: The veins were removed from the axilla during surgery and there is poor circulation now is not the correct explanation because it is not true. The veins are not removed during a radical mastectomy, only the lymph nodes are. The veins are part of the circulatory system, which carries blood throughout the body. The blood flow to the arm and hand is not affected by the surgery, unless there is a complication such as a blood clot or an infection.

Choice D reason: You will need to wear a compression bandage to help fluids move from the area is not the correct explanation because it is a treatment, not a cause. A compression bandage is a type of elastic bandage that applies pressure to the arm and hand, which helps to reduce the swelling and prevent further fluid accumulation. However, it does not address the root cause of the edema, which is the removal of the lymph nodes.

Choice A reason: Decreased dietary intake of proteins and vegetables is not the best explanation because it is a factor that affects the nutritional status, not the immune system. Nutritional status is important for maintaining the health and function of the body, but it does not directly cause an increased risk of infection. Proteins and vegetables are sources of essential nutrients, such as amino acids, vitamins, minerals, and antioxidants, that support the growth and repair of the tissues and the prevention of oxidative stress.

Choice B reason: Decreased T cell function and antibody response is the best explanation because it is a factor that affects the immune system, which is the body's defense mechanism against foreign invaders, such as bacteria, viruses, and fungi. The immune system consists of two main components: the innate immunity and the adaptive immunity. The innate immunity is the first line of defense that provides a general and rapid response to any potential threat. The adaptive immunity is the second line of defense that provides a specific and long-lasting response to a particular antigen. T cells and antibodies are part of the adaptive immunity, which recognizes and remembers the antigens that have previously infected the body and eliminates them more efficiently. However, as people age, the T cell function and the antibody response decline, making the older adults more susceptible to infections, especially those that are new or unfamiliar to the body.

Choice C reason: Atrophy of the bone marrow and spleen is not the best explanation because it is a factor that affects the production and storage of immune cells, not the function and response. The bone marrow is the soft tissue inside the bones that produces the blood cells, including the white blood cells, which are the main components of the immune system. The spleen is an organ that filters the blood and removes the old or damaged blood cells, as well as stores some of the white blood cells and platelets. As people age, the bone marrow and the spleen shrink and lose some of their ability to produce and store the immune cells, which can reduce the number and diversity of the immune cells available to fight infections. However, this does not necessarily affect the function and response of the immune cells that are already circulating in the blood.

Choice D reason: Impaired absorption of vitamin B12 is not the best explanation because it is a factor that affects the nervous system and the blood cells, not the immune system. Vitamin B12 is a water-soluble vitamin that is essential for the synthesis of DNA, the maintenance of the myelin sheath, and the formation of red blood cells. As people age, the absorption of vitamin B12 decreases due to the reduced secretion of stomach acid and intrinsic factor, which are needed to break down and bind to the vitamin B12 in the food. This can lead to vitamin B12 deficiency, which can cause symptoms such as fatigue, weakness, numbness, tingling, memory loss, and anemia. Anemia is a condition where the blood has a low level of hemoglobin, which is the protein that carries oxygen in the red blood cells. Anemia can affect the oxygen delivery to the tissues, but it does not directly cause an increased risk of infection.