Blood pressure of 180/120 mmHg or higher (hypertensive crisis) is reported and evaluated immediately.
Before you read
Test yourself first: 5 questions
Question 1 of 5
Screening an older adult for depression, the nurse recognizes that in this population depression often presents as:
Answer: B. Older adults may present with somatic complaints, memory issues, social withdrawal, and decreased function rather than classic sadness — screen carefully and don't dismiss it as 'just aging.'
Question 2 of 5
An older adult takes many medications. The nurse is most concerned about:
Answer: B. Polypharmacy increases the risk of drug interactions, adverse effects, and falls in older adults — review the full list and reconcile regularly.
Question 3 of 5
A nurse is teaching an older adult about fall prevention to reduce the risk of fractures at home. Which recommendation is MOST appropriate?
Answer: B. Removing throw rugs and clutter, ensuring adequate lighting, installing grab bars, and wearing non-skid footwear reduce fall and fracture risk in older adults. Loose rugs and dim lighting increase the risk of falls.
Question 4 of 5
A 70-year-old asks which immunizations are recommended for older adults. Which response by the nurse is accurate?
Answer: A. An annual influenza vaccine is recommended for adults regardless of age, including older adults. The shingles series is recommended for adults 50 and older, pneumococcal vaccination is recommended for those 65 and older, and there is no upper age cutoff that stops routine vaccination simply because of advanced age.
Question 5 of 5
A nurse is counseling an older adult at a community center about vaccines. Which vaccine is routinely recommended annually for adults?
Answer: A. The influenza vaccine is recommended annually for adults because the circulating strains change each year. The shingles (zoster), pneumococcal, and Tdap vaccines are given on different schedules, not every year.
Keep the streak going with more questions like these, each with a full rationale.
What is adult preventive screening?
Recommendations are age and risk based, covering blood pressure, lipids, diabetes, and lifestyle. Primary prevention prevents disease, secondary screening detects it early, and tertiary care limits complications.
Key points to remember
- Blood pressure should be screened at least every 1-2 years in adults to detect hypertension early.
- Lipid screening is recommended starting around age 40, or earlier with cardiovascular risk factors.
- Adults are screened for type 2 diabetes with risk factors such as overweight or age 35-70.
- Annual screening includes tobacco, alcohol, and depression assessment in adults.
- Obesity screening uses BMI; counseling is offered for a BMI of 30 or higher.
- Bone density screening (DEXA) begins at age 65 for women and earlier with risk factors.
Nursing priorities
- Measure and document blood pressure at every encounter and flag elevated readings.
- Screen for depression, tobacco use, and alcohol misuse and provide referral or counseling.
- Calculate BMI and counsel on diet, exercise, and weight management.
- Verify the patient is current on age-appropriate cancer screening and immunizations.
- Educate on and arrange diabetes and lipid screening based on age and risk.
Labs & values
Patient teaching
- Emphasize that screening finds disease early when it is most treatable, even without symptoms.
- Counsel on a balanced diet, regular physical activity, smoking cessation, and limiting alcohol.
Red flags: report now
- Blood pressure of 180/120 mmHg or higher (hypertensive crisis) is reported and evaluated immediately.
- Unintentional weight loss, new severe symptoms, or a positive depression and suicide screen require prompt follow-up.
References
Clinical references for this topic
