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Zorluk: Çok zorHealth Promotion and Disease Prevention

A 68-year-old client is being evaluated at an outpatient clinic for a routine follow-up. The client has a history of severe rheumatoid arthritis treated with ongoing immunosuppressant therapy, osteoporosis, and adheres to a strict lacto-ovo vegetarian lifestyle. The client's spouse expresses concern, stating, 'Since yesterday morning, my spouse has been extremely agitated and cannot remember what day it is.' The provider has ordered several routine health maintenance interventions. Which of the following actions should the practical nurse take? (Select all that apply.)

  1. A
    Proceed with giving the prescribed live measles, mumps, and rubella (MMR) booster injection to update the client's viral immunity.
  2. B
    Reassure the spouse that sudden memory loss and agitation are typical, age-related cognitive changes for adults over 65.
  3. Gather a midstream urine specimen and obtain a full set of vital signs to screen for a potential underlying infection.Cevap
  4. D
    Suggest incorporating baked poultry or fish into the client's weekly meal plan to provide adequate protein for tissue repair.
  5. Reinforce previous teaching about consuming dairy products, leafy green vegetables, and fortified cereals to support bone density.Cevap
  6. Review infection control practices with the client and spouse, emphasizing the need to avoid crowds and individuals who are ill.Cevap

Cevap

The appropriate actions are to gather a urine specimen and check vital signs to investigate the sudden confusion, reinforce teaching on calcium-rich vegetarian foods to support bone health, and review infection control practices due to the client's immunosuppressant therapy.
Health promotion and disease prevention require a holistic approach to the client's complex needs. Sudden cognitive changes like agitation and memory loss in an older adult are classic signs of delirium, frequently triggered by infections; therefore, obtaining vital signs and a urine specimen is a critical secondary prevention measure. The client's use of immunosuppressant therapy increases susceptibility to illness, making infection control education an essential primary prevention strategy while firmly contraindicating live vaccines. Furthermore, reinforcing the intake of dairy products and fortified cereals supports bone density for osteoporosis while perfectly aligning with the client's lacto-ovo vegetarian lifestyle.

Adım Adım Çözüm

1
Analyze the client's acute neurological presentation.
The sudden onset of memory loss and agitation indicates delirium, not normal aging or progressive dementia.
Delirium in older adults is frequently a secondary symptom of an underlying infection (such as a UTI). Initiating screening by collecting vital signs and a urine specimen is a priority action.
2
Evaluate the impact of the client's medication regimen on planned interventions.
The client's active use of immunosuppressant therapy contraindicates the administration of any live-attenuated vaccines.
An immunosuppressed client cannot safely mount a defense against live viruses. The MMR vaccine must be withheld, and proactive infection control education must be prioritized instead.
3
Assess the client's nutritional requirements against their stated dietary restrictions.
The client requires calcium for osteoporosis but follows a strict lacto-ovo vegetarian diet.
Meat, poultry, and fish must be avoided. The nurse should reinforce the consumption of dairy, leafy greens, and fortified cereals to provide necessary calcium within the boundaries of the client's lifestyle.

Anahtar Kavram

Synthesizing disease prevention strategies across multiple complex variables, including medication contraindications, dietary restrictions, and distinguishing acute delirium from normal aging.
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Konular

Health Promotion and Disease Prevention

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