Kaplan Gerontology A Part 2-with 100% verified solutions-2023-2024
The nurse provides care for several older clients. Which client does the nurse
assess first?
A. the client reporting a gradual change in the ability to walk w/o stumbling
B. the client reporting constipation for several days
C. the client showing signs of urinary frequency and urgency
D. the client displaying difficulty speaking and moving the right arm
D
The client who has difficulty speaking and moving may be experiencing a stroke, and
this needs to be assessed immediately. If a stroke is occurring, it needs to be treated
immediately to avoid permanent damage
A: this client's changes have been gradual, and while it is important to determine the
cause, it is not the first problem needing attentiion
B: constipation is common in older clients because of changes to the digestive
system and dehydration. It is not the most urgent problem to address
C: urinary frequency and urgency are common changes that occur w/aging due to
changes in the musculature of the body. This is not the most urgent problem to
assess
Priorities
Enable nurse to attend to client's most important needs
Helps nurse organize care
Situations that if left untreated could cause physical harm to client have the highest
priority
Using Maslow's hierarchy of needs
Enables nurse to establish priorities
Priorities: implementation: develop a prioritized list of nursing diagnoses
High-priority: involve diagnoses that, if left untreated, could cause physical harm to
pt
Medium priority: involve non-life-threatening diagnoses
Low priority: involve diagnoses not specifically related to current health problem
Priority: implementation
Deal w/medical problems (or suspected medical problems) first; consider all health
needs and determine relationship between problem
Priority: implementation: prioritize needs in terms of Maslow's hierarchy
Help pt meet basic phsiologic needs (oxygen, water, food, temperature, elimination,
sexuality, physical activity, and rest)
Priority: implementation: assist pt w/safety and security needs
Effective handwashing and sterile techniques
Proper use of electrical equipment
Proper administration of medications
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