Concerns about alcohol intake during adolescence is highest priority, regardless of whether or not it is stored in the home. Alcohol-related injury and death are a risk that should be avoided in every circumstance. Not having alcohol in the house does not guarantee the teenager wont consume it with his friends. During the teen years, the relationships among peers strengthen and strongly influence adolescent behavior. Although the parents typically still maintain influence on the core values in the home, teens seek peers opinions for matters about social life or concerns of everyday living. As teens are developmentally concerned with appearance and social relationships, there can be an overemphasis on body image, leading to obesity, as well as eating disorders. Motor vehicle accidents are the leading cause of death for teenagers, typically due to distractibility, inattention, impulsiveness, and inexperience in various driving situations.
With aging, there is decreased pupil accommodation, decreased tear production, and thickening of the lens of the eye. All of these contribute to impaired near vision (presbyopia). Decrease in pupil accommodation allows less light into the eye, so in order to read, the person needs a good light. However, there is also increased sensitivity to glare, so the light should have a glare-free bulb. The patient should try this first, since she already has new glasses. If this doesnt help, then perhaps she should have the glasses rechecked. If her vision cannot be improved, then she could think about buying audio books and other ways to adapt to her difficulty reading.
The scenario describes a retirement community. A naturally occurring retirement community is one in which the person ages in place, living in the same home as always and in a neighborhood where the neighbors have aged together and have provided support for each other through the years. A continuing care retirement community is residential living (e.g., cottages, cluster homes, apartments) into which a person must move. The person pays an entrance fee and monthly fees. In return, the contract provides for assistance with activities of daily living, coordinated social activities, health monitoring, and so on. There is usually a health clinic on site. Assisted living facilities (ALFs) are congregate residential settings that provide or coordinate personal services, 24-hour supervision and assistance (scheduled and unscheduled), activities, and health-related services. State regulations and level of services preclude residents from staying in an ALF when their needs become greater than the resources and services provided.
ANS: 1, 2, 3
Incontinence is not a normal part of aging and should be explored further. The thinning of the layers of the skin causes older adults to feel colda normal part of aging. With aging, the brown fat layer, which contributes to generating and maintaining body temperature, becomes thinner as well. This is not the same type of fat as adipose, which is a white fat layer. Additionally, older adults who are sedentary often feel cooler. The elderly normally experience a decrease in saliva production, so although this is also a symptom of dehydration, dry mouth is a normal change of aging. Visual acuity decreases with age, but this, too, is a normal part of aging.
ANS: 1, 3, 4
This client has the characteristics of frailty: low physical activity, muscle weakness, fatigue, and slowed performance. Clearly, the client is not able to perform ADLs adequately; therefore, a home aide is needed. Adapted physical activity programs are designed for adults in better physical health, not for frail elders. The client would be unlikely to benefit from an APA and probably could not even participate in such a group activity. Depression and impaired mental abilities tend to accompany frailty, so it is important to assess those for this client. Nutrition is essential to slow the progression of frailty, so having meals delivered is both appropriate and important.
The home environment, community, family, friends, and support system all influence health status. The balance among these variables has a net positive or negative effect on a clients health status. The effect of poor living conditions may be offset by the presence of loving family and friends. Poverty does not always have a negative effect on health. Similarly, the presence of food, shelter, and clothing does not always convey protective health, as loneliness and hopelessness may counteract these positive influences. When examining the clients environment, extended boundaries must be considered, especially when providing community-based care.
The patient experiencing severe anxiety may experience physical symptoms including headache, palpitations, tachycardia, insomnia, dizziness, nausea, trembling, hyperventilation, urinary frequency, and diarrhea. Symptoms associated with mild anxiety include muscle tension, restlessness, irritability, and a sense of unease. The patient experiencing moderate anxiety might experience a rise in heart rate and respiratory rate, increased perspiration, gastric discomfort, and increased muscle tension. The patient suffering from panic anxiety might believe he has a life-threatening illness. Physical symptoms include dilated pupils, labored breathing, severe trembling, sleeplessness, palpitations, diaphoresis, pallor, and uncoordinated muscle movements.
The nurse is assessing a patient for depression. Which of the following sets of behavioral symptoms may indicate depression?
Preoccupation with loss, self-blame, and ambivalence
Anger, helplessness, guilt, and sadness
Anorexia, insomnia, headache, and constipation
Tearfulness, withdrawal, and present substance abuse
Tearfulness, regression, restlessness, agitation, withdrawal, past or present substance abuse, and a past history of suicide attempts are all behavioral symptoms of depression. Denial of feelings, anger, anxiety, guilt, helplessness, hopelessness, and sadness are affective findings associated with depression. Cognitive findings in depression include preoccupation with loss, self-blame, ambivalence, and blaming others. Physiological findings of depression include anorexia, overeating, insomnia, hypersomnia, headache, backache, chest pain, and constipation.
ANS: 1, 3, 4
Culture is learned through life experiences that are shared by other members of the culture, such as family members, those sharing similar religious beliefs, and people of similar cultural heritage in the same community. Culture exists at many levels that are both material and nonmaterial. Cultural customs, beliefs, attitudes, and practices are not static but change over time at different rates, depending on current events, other significant people, and social influences. Culture is all encompassing and affects everything its members think and do; it is not limited to food and holidays. Although those are visible manifestations of a culture, dietary practices and cultural calendars are not the essence of true and meaningful culture.
Those of Hindu faith typically practice Ayurvedic medicine, which encompasses all aspects of life, including diet, sleep, elimination, and hygiene. Some believe in the medicinal properties of hot and cold foods, which have nothing to do with temperature or degree of spiciness. People who practice Hinduism do not typically practice Western medicine, chiropractic medicine, or Qigong. Qigong, a form of Chinese martial arts, is used to achieve healing through focus on the bodys energy centers.
ANS: 1, 2, 3, 4
Reasons for not reporting rape include fear of the assailant, fear of consequences to the assailant, knowledge of the low conviction rate for rapists, the desire to avoid a trial, shame and embarrassment, past sexual history, self-blame, and wanting to move on and not face possible consequences involving pregnancy and sexually transmitted infection.
ANS: 1, 3, 4
Low libido, arousal disorder, and orgasmic disorder all affect the sexual response cycle. These disorders affect desire, arousal, excitement, and orgasm. Rape occurs when there is nonconsensual vaginal, anal, or oral penetration. It occurs through force, by the threat of bodily harm, or when the victim is incapable of giving consent. Date rape is forced, unwanted sexual intercourse by an acquaintance when the assault occurs during an agreed-upon social encounter.