A nurse is assessing an older adult client. Which of the following should the nurse identify as an expected physiological change associated with aging?

Choice A rationale:

Chronic grief is characterized by a prolonged and ongoing sense of loss that doesn't seem to improve with time. It doesn't directly relate to maladaptive coping, which the client in the scenario is exhibiting. Chronic grief may involve a persistent yearning or sadness for the deceased, but it doesn't necessarily involve maladaptive coping strategies.

Choice B rationale:

The client's use of alcohol and controlled substances to cope with the death of their partner indicates an exaggerated grief response. Exaggerated grief involves an intense and prolonged expression of grief that may be accompanied by excessive, intense emotions and behaviors. The client's use of substances to cope is an unhealthy and maladaptive way of dealing with their grief.

Choice C rationale:

Delayed grief refers to a situation where the emotional response to a loss is significantly postponed, often resulting in a delayed and intense reaction later on. It doesn't necessarily involve maladaptive coping, as seen in the client's case.

Choice D rationale:

Masked grief occurs when the grieving person's behavior and emotional responses are influenced by the loss but not recognized as being related to it. This can lead to various physical or psychological symptoms that mask the true underlying cause, the grief. While maladaptive coping can sometimes be seen in masked grief, it doesn't directly correlate with the client's substance use in this scenario.

Choice A rationale:

Apply the skin sealant on damp skin. Rationale: Applying skin sealant on damp skin is not the recommended approach for securing an ostomy appliance. It's important to ensure that the skin is clean and dry before applying the sealant or the skin barrier. Moisture can compromise adhesion and lead to skin irritation or appliance detachment.

Choice B rationale:

Remove the appliance before emptying the pouch. Rationale: Removing the appliance before emptying the pouch is not a necessary step when changing an ostomy appliance. Typically, the pouch can be emptied without removing the entire appliance, which helps maintain the seal and reduces unnecessary skin exposure.

Choice C rationale:

Ensure that the skin is slightly damp for better adhesion of the pouch. Rationale: Ensuring that the skin is slightly damp is not advisable for better adhesion of the pouch. The skin should be completely dry before applying the pouch to ensure proper adhesion. Moisture on the skin can lead to leakage or detachment of the appliance.

Choice D rationale:

Trace the size of stoma onto the skin barrier. Rationale: This choice is the correct answer because tracing the size of the stoma onto the skin barrier ensures a precise fit, which is crucial for preventing leaks and maintaining the integrity of the ostomy. A proper fit also helps in preventing skin irritation and discomfort. Choosing the correct barrier size based on the stoma's dimensions is a key aspect of effective ostomy care.