A nurse in a provider's office is caring for a client.

Exhibit 1

Medical History

Initial visit:

Client reports a sedentary lifestyle.

Client is lactose intolerant and denies taking vitamin supplements.

Client is a nonsmoker.

Client does not drink alcohol.

The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for osteoporosis? (Select all that apply.)

A. Grab bars are installed in the shower: Installing grab bars in the shower is a safety measure that helps prevent falls and assists the client in safely maneuvering in the bathroom. This finding indicates a safe environment and does not require intervention.

B. The hot water heater is set to 47°C (117°F): The hot water heater set at 47°C (117°F) poses a scalding risk, especially for older adults with decreased sensation or mobility issues. The recommended safe temperature for hot water heaters is typically below 49°C (120°F) to prevent burns. Therefore, the nurse should intervene to adjust the temperature to a safer level.

C. There is an area rug covering a tile floor.

Area rugs covering tile floors can pose a significant fall risk, especially for older adults with osteoporosis, who are more susceptible to fractures. The rug can slip or bunch up, leading to trips and falls. Therefore, the nurse should intervene to remove the area rug or secure it firmly to the floor to prevent accidents.

D. Prescriptions are stored in a medication organizer: Storing prescriptions in a medication organizer promotes medication adherence and organization, which is beneficial for older adults managing multiple medications. This finding indicates good medication management and does not require intervention.

A. Antibiotic medication can be taken with or without food.

This statement is not specifically relevant to the discharge teaching for this client with pneumonia. However, the nurse should provide specific instructions regarding the administration of the antibiotic (cefazolin), which is typically administered intravenously in a healthcare setting and may not be taken orally at home.

B. The steroid dose will decrease each day.

Explanation: This information ensures that the client and caregiver are aware of the tapering regimen for the steroid medication (prednisone), which is essential to prevent adrenal insufficiency and other potential adverse effects associated with abrupt discontinuation.

C. Adjust the oxygen flow rate as needed to ease breathing.

Explanation: This information educates the client and caregiver on how to manage oxygen therapy effectively at home, ensuring optimal oxygen delivery and respiratory support.

D. Antibiotic therapy should be taken for 10 days.

The duration of antibiotic therapy for pneumonia depends on the specific antibiotic prescribed and the severity of the infection. The nurse should provide clear instructions based on the healthcare provider's prescription and guidelines.

E. Store the oxygen cylinder wrench with the oxygen tank.

While storing the oxygen cylinder wrench with the oxygen tank is a good practice, it is not directly related to discharge teaching for this client with pneumonia.

F. Steroid medication should be taken in the morning.

Explanation: Taking steroid medication (prednisone) in the morning helps minimize disruption of the body's natural cortisol rhythm and reduces the risk of insomnia associated with steroid use.

G. Ensure the oxygen delivery system is at least 8 feet from any heat source.

Explanation: Proper storage and placement of the oxygen delivery system reduce the risk of fire hazards associated with oxygen therapy, promoting safety within the home environment.