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Cranial Nerves: 1. A nurse is about to conduct a physical assessment of an 82-year-old patient.  ...

Cranial Nerves:

1. A nurse is about to conduct a physical assessment of an 82-year-old patient.  

What questions should the nurse ask to determine the best approach to this examination based on the patient’s physical and emotional needs?

2.Assessment of the eyes will primarily focus on which cranial nerves?

Assessing Older Adults

1. A nurse is about to create a teaching plan for an older adult patient that focuses on health promotion and risk reduction.

a. Which areas of health promotion and counseling are specific to the older adult?

b. Which screening tools are appropriate in the assessment of older adults?

Cranial Nerves:

1. A nurse is about to conduct a physical assessment of an 82-year-old patient.  

What questions should the nurse ask to determine the best approach to this examination based on the patient’s physical and emotional needs?

2.Assessment of the eyes will primarily focus on which cranial nerves?

Assessing Older Adults

1. A nurse is about to create a teaching plan for an older adult patient that focuses on health promotion and risk reduction.

a. Which areas of health promotion and counseling are specific to the older adult?

b. Which screening tools are appropriate in the assessment of older adults?

Solutions

Expert Solution

Before taking history and physical examination of this 82 year old patient you should know what are the main problems a person of this age can have.

Main problems expected are

Immobility

Instability

Incontinence

Intelectual impairment.

So questions should be focused on these 4 common problems of old age.Immobility leads to bedridden state and related problems like pressure sores.instability leads to risk of falls cause of which may be muscle weakness,gait or balance abnormality,visual impairment,arthritis etc.

intellectual impairment may be due to depression,dementia,and cognitive impairment or due drugs he is on usually polypharmacy.So detailed history regarding his medication and comorbid illness is essential.

Urinary incontinence is a major problem for elderly.Risk factors are functiional impairment,dementia,smoking,affective disorder,constipation etc.Prostatic hypertrophy,prostatic cancer or urethral stricture are also common in males of this age.Detruser atony due to autonomic neuropathy,diabetes,alcoholism,Partkinson's disease all lead to incontence.

Physical examinatiion should include

Postural vital signs

Vision evaluation

Gait and balance tests

Musculoskeletal evualuation of joint stability and range of motion.

2.Assessment of eyes will focus on which cranial nerves?

Optic nerve or 2nd craial nerve involved with acuity of vision

Oculomotor nerve or 3rd cranial nerve,Trochlear nerve or 4th cranial nerve and Abducens nerve or 6th cranial nerve all invoved in eye movements

Facial nerve or 7th cranial nerve involved in eye closure

3.Health promotion and counselling specific for older adults

This includes

Support-Help them in staying independent and functional

know age related body structure and function

Differentiate age related changes from pathological states

Detect new risk factors and deficiencies in activies of daily living

Regular monitoring of existing health problems

monitoring the effectiveness and side effects of their medications

Assis them in health promotion and disease prevention.

Aim of counselling of elderly is to improve the wellbeing and consequently quality of life of these people.

3.Screening tools appropriate for assessing elderly

Functional assessment tools like Katz index of independence in activities of daily living is most appropriate scale to screen for basic functional activites of elderly.Data to be collected from patient,family members or care givers.

MULTIPLE QUESTIONS.NO TIME TO WRITE MORE THAN THIS.SORRY.HOPE THIS WILL HELP.


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