A licensed practical nurse is discussing assessment findings for several older adult clients with the registered nurse (RN). Which client is priority for the RN to assess?

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11ecbb05_cbe2_9f73_b433_19a486bc2105_MD0009_00 An S3 sound is made when blood from the atrium is pumped into a noncompliant ventricle. S3 is heard after S2 (ventricular gallop). It may present as a normal finding in young adults. However, a new S3 in older adults is a significant finding as it may indicate development of volume overload or heart failure. These conditions require prompt intervention as they may rapidly progress to life-threatening events (eg, respiratory compromise, cardiogenic shock). This client may be receiving excessive IV fluids that are causing volume overload (Option D). (Option A) Metoprolol is a beta adrenergic blocker often used to treat heart failure and hypertension. Common side effects of beta blockers are bradycardia and hypotension. The health care provider should be notified if the client develops heart rate <50/min, hypotension, or cardiac symptoms (eg, dizziness, lightheadedness, nausea, chest pain) before or after administration. (Option B) Chronic obstructive pulmonary disease (COPD) is a lung disorder that often causes dyspnea, hypoxia, and hypercarbia due to irreversible remodeling of the lower airways. The oxygen saturation goal for such clients is often 88%-92%. (Option C) Repeated high gastric residual volumes (>250 mL) in clients receiving enteral feedings may indicate delayed stomach emptying and require adjustment to prevent nausea, vomiting, or abdominal distension. Educational objective: An S3 sound can be an expected finding in young adults. However, a new S3 sound in older adults requires prompt evaluation as it is often a sign of volume overload or heart failure.

A Licensed Practical Nurse Is Discussing Assessment Findings for Several