A home health nurse is making a home visit to an older adult client. A nurse conducts a home safety assessment and screens the environment for potential hazards for falls. The nurse recommends that the client eliminate which of the following? (Select all that apply.)

A. A standard assessment tool will increase the likelihood of obtaining accurate data.

Explanation: Standardized assessment tools, like the Mini-Cog, are designed to provide consistent and objective measures of specific aspects of a client's health, in this case, mental status. Using such tools helps ensure a standardized and systematic approach to data collection, increasing the reliability and accuracy of the information gathered. This, in turn, contributes to a more comprehensive understanding of the client's health status.

B. A standard assessment tool is required by Medicare and Medicaid.

Explanation: While some standardized assessment tools may be recommended or required by certain healthcare agencies or institutions, there isn't a broad requirement from Medicare and Medicaid for a specific tool. The use of assessment tools may vary based on clinical judgment and institutional policies.

C. A standard assessment tool will increase reimbursement by Medicare and Medicaid.

Explanation: The use of a specific assessment tool is not a direct factor that influences reimbursement by Medicare and Medicaid. Reimbursement is typically based on the overall care provided and documented, rather than the specific assessment tool used.

D. A standard assessment tool will increase the client's confidence in the nurse.

Explanation: While utilizing a standard assessment tool may contribute to the overall professionalism and thoroughness of care, the primary purpose is to obtain accurate and objective data rather than specifically increasing the client's confidence in the nurse. Confidence is often influenced by the nurse's communication, empathy, and overall competence in providing care.

A. Hearing.

While hearing impairment can affect overall awareness, it is not as directly linked to the risk of falls as vision, cognitive disorders, and blood pressure-related issues.

B. Vision.

Correct. Visual impairment can contribute to an increased risk of falls.

C. Cognitive disorders.

Correct. Cognitive impairment or disorders can impact a person's awareness and ability to navigate their environment safely.

D. Preprandial hypotension.

Correct. Low blood pressure before meals (preprandial hypotension) can contribute to dizziness and falls, especially in older adults.

E. Orthostatic hypotension.

Correct. Orthostatic hypotension, a drop in blood pressure upon standing, is a risk factor for falls.