A nurse is assessing a client's pulmonary artery wedge pressure (PAWP). The nurse should recognize that an elevated PAWP indicates which of the following complications?

Rationale:
A. A client who has dementia and is incontinent of urine: Cognitive impairment and incontinence significantly increase the risk for pressure injuries. Dementia may limit mobility and the ability to communicate discomfort, while moisture from incontinence leads to skin breakdown, making this client the highest risk.

B. A client who has had a recent myocardial infarction: While immobility after a myocardial infarction can contribute to pressure injury risk, this client typically has fewer direct risk factors compared with incontinence and cognitive impairment.

C. A client who has a T-tube following an open cholecystectomy: Postoperative clients with a T-tube are at moderate risk due to temporary immobility, but they usually maintain mobility and can reposition, reducing overall risk compared with incontinent or cognitively impaired clients.

D. A client who is 2 days postoperative following orthopedic surgery: Early postoperative orthopedic clients are at risk due to immobility, but with appropriate repositioning, pressure-relieving devices, and monitoring, their risk is generally lower than a client with incontinence and dementia.

Rationale:
A. The client takes multiple steps while holding the walker: Taking several steps while holding the walker increases the risk of imbalance and falls. The correct technique is to move the walker forward one step length, ensure all four legs are stable on the ground, and then take a single step toward it before moving the other leg.

B. The client lifts the walker as it is moved forward: The walker should be lifted slightly and placed firmly on the ground to ensure stability with each step. Sliding the walker instead of lifting it can cause uneven movement or tipping, especially on rough surfaces, making lifting the correct method.

C. The client advances the walker and takes a step towards it: This is the proper technique for safe use. The client should advance the walker first, then step forward with the weaker leg, followed by the stronger leg, maintaining balance and even weight distribution.

D. The client grasps the walker by the hand grips on the upper bars: Proper hand placement on the upper hand grips ensures stability and correct posture during ambulation. Holding the walker anywhere else can cause poor control, imbalance, or wrist strain.