Chapter 08: Laboratory Values and Diagnostics Touhy: Ebersole & Hess' Toward Healthy Aging, 9th Edition MULTIPLE CHOICE 1. The nurse is reviewing the postsurgical laboratory values of an older adult client. The client’s
erythrocyte sedimentation rate (ESR) is 20 mm/hr. The nurse initially responds to this data by: a. asking the client if he or she has been diagnosed with any chronic inflammatory diseases. b. recognizing that the value is normal for older adults. c. notifying the client’s health care provider immediately. d. requesting that the laboratory rerun the test. ANS: B
The ESR can be slightly elevated (10-20 mm/hr) in healthy older adults, especially those with a chronic disease that results in inflammation. Asking the client if he or she has such a diagnosis is not the initial response. This slight elevation does not warrant immediate notification or rerunning of the test. DIF: Cognitive Level: Applying REF: p. 91 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 2. An older client in a long-term care facility is receiving an annual physical examination and is
ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the client’s son questions why these tests are being ordered by saying, “Dad is 85 why are you bothering him?” the nurse’s response is based on an understanding that: a. the health care provider ordering the tests needs to explain the rationale to the son. b. when conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting. c. the tests are useful, but only if clinically indicated. d. the complete blood count and serum electrolytes are useful screening tests, but the usefulness of the thyroid test should be questioned. ANS: B
Laboratory tests are a fast and accurate way of assessing key parts of an older person’s physical functioning. It is within the nurse’s scope of practice to answer the son’s question and it does not need to be referred to the health care provider. The laboratory tests are being used as annual screening and therefore do not need to be clinically indicated. Excessive sleepiness is not normal in an 85-year-old and may be a sign of a thyroid disorder. DIF: Cognitive Level: Applying REF: p. 92 TOP: Integrated Process: Teaching/Learning MSC: Client Needs: Physiological Adaptation 3. When asked by an older adult client, “What is the difference between my normal laboratory
values and the ones for a 55-year-old?” The nurse responds based on the understanding that there are: a. age-adjusted ranges for older adults for all of the common laboratory findings, similar to those for infants and children.
