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Difficulty: HardHealth Promotion and Disease Prevention

A 68-year-old male client presents to the outpatient clinic for an annual health maintenance visit. The client's past medical history includes essential hypertension and a 25-pack-year smoking history, though he reports successfully quitting smoking five years ago. When formulating the client's care plan, which action by the nurse represents an appropriate secondary disease prevention strategy specifically indicated for this client's demographic and risk profile?

  1. Facilitating a one-time screening ultrasonography of the abdominal aorta.Answer
  2. B
    Administering the high-dose inactivated influenza vaccine for the current respiratory season.
  3. C
    Providing education on the Dietary Approaches to Stop Hypertension (DASH) eating plan to manage blood pressure.
  4. D
    Scheduling a routine dual-energy x-ray absorptiometry (DEXA) scan to evaluate bone mineral density.

Answer

Facilitating a one-time screening ultrasonography of the abdominal aorta.
Secondary prevention focuses on the early detection of asymptomatic disease through screening. According to evidence-based guidelines, a one-time screening ultrasonography for an abdominal aortic aneurysm (AAA) is indicated for men aged 65 to 75 years who have a history of smoking. This client perfectly fits the demographic and risk profile for this secondary prevention strategy.

Step-by-Step Solution

1
Analyze the client's demographic and clinical profile.
The client is a 68-year-old male with a history of hypertension and a significant smoking history (25 pack-years).
Identifying age, gender, and risk factors is essential for determining appropriate evidence-based screening guidelines.
2
Define the goal of secondary prevention.
Secondary prevention involves screening measures to detect asymptomatic diseases early.
The question specifically asks for a secondary prevention strategy, eliminating primary interventions (vaccines) and tertiary interventions (disease management).
3
Evaluate each intervention against prevention levels and demographic indications.
An AAA ultrasound is a secondary prevention measure indicated for males aged 65-75 who have ever smoked. The influenza vaccine is primary. The DASH diet for existing hypertension is tertiary. A DEXA scan is secondary but typically indicated for females over 65.
Matching the correct prevention level with the specific demographic guideline isolates the correct answer.

Key Concept

Epidemiological Framework of Prevention and Age-Specific Screenings
Estimated Time:1m 15s
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Topics

Health Promotion and Disease Prevention

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