COURSE  

NRNP 6540 Advanced Practice Care of Older Adults

1. Question: When performing an assessment on patients over 65 years of age, what are at least three (3) key symptoms that may indicate cardiovascular disease?
2. Question: You diagnose your older patient with intermittent asthma. List at least three (3) criteria for the diagnosis of intermittent asthma.
3. Question: Mrs. L is a 71-year-old Hispanic female with a PMH of seasonal allergies and her only medication is aspirin 81 mg; she presents to the clinic with the following symptoms: Recurrent wheezing, cough (especially occurring at night), recurrent chest tightness, and dyspnea on exertion. She also complains of a chronic rhinorrhea with postnasal drip. Please list four (4) differential diagnoses for these symptoms.
4. Question: Your 69-year-old African American female patient has a PMH of asthma. You know that In the United States, asthma is more prevalent in African Americans. List at least three (3) factors that contribute to development of asthma.
5. Question: A 78-year-old patient, past one ppd smoker times 10 years (quit 10 years ago) presents with increasing shortness of breath, dyspnea on exertion, and no other symptoms. Name two diagnostic tests you could order to differentiate between asthma and COPD.
6. Question: According to the GOLD Pocket Guide to COPD Diagnosis, Management, and Prevention, A Guide for Health Care Professionals, 2017, what would the predicted FEV be for GOLD 4 very severe COPD?
7. Question: You are performing a Medicare home assessment on an 84-year-old male. Part of this exam is checking for carotid bruits. Describe two reasons this exam is important in an older adult:
8. Question: Edna is a typically healthy 80-year-old patient who is now complaining of new shortness of breath when she climbs stairs at home, and she states she has been more tired than usual. List three ROS questions you would want to ask her, using the OLDCARTS method.
9. Question: Your 69-year-old patient who has daily asthma symptoms with nighttime awakenings weekly but not nightly, and an FEV >60 but <80 would have the diagnosis of what type of asthma?
10. Question: Pharmacological therapy for COPD has a significant role in reducing symptoms, reducing exacerbation frequency and severity, along with improving exercise tolerance, health status, and quality of life. Describe two pharmacological regimens for COPD with rationale, names of medications, duration of action, two side effects, and stage of COPD you would use this medication.

SOLUTION  

1. When performing an assessment on patients over 65 years of age, what are at least three (3) key symptoms that may indicate cardiovascular disease?

When assessing a patient over 65 years old, the key symptoms that may indicate cardiovascular disease include dizziness, syncope, orthopnea, angina, edema, and claudication. Syncope can occur due to asystole or an intermittent symptom may be due to an underlying arrhythmia. Orthopnea may indicate a patient with heart failure.

Intermittent claudication is an early symptom of peripheral artery disease.

2. You diagnose your older patient with intermittent List at least three (3) criteria for the diagnosis of intermittent asthma.

When diagnosing intermittent asthma, the following criteria must be satisfied: symptoms should occur equal or less than twice a week; nightime awakenings should be equal or less than twice a month; short-acting-beta -agonist use for symptom control is equal or less than twice a week; there should be no interference with normal activity………..please click the icon below to purchase all solutions at $10