A nurse is assessing an older adult client who has a history of falls.

Which of the following findings should the nurse identify as a risk factor for falls in older adults?

The correct answer is C.

Ego integrity vs despair.

According to Erikson’s psychosocial theory, older adults face the challenge of looking back on their lives and evaluating their accomplishments and failures.

If they feel satisfied with their life course, they achieve a sense of ego integrity, which is a feeling of wholeness and coherence.

If they feel regretful or dissatisfied, they experience despair, which is a sense of hopelessness and bitterness.

Choice A is wrong because trust vs mistrust is the first stage of Erikson’s theory, which occurs in infancy.

It involves developing a basic sense of trust in oneself and others based on the quality of caregiving.

Choice B is wrong because generativity vs stagnation is the seventh stage of Erikson’s theory, which occurs in middle adulthood.

It involves contributing to society and the next generation through work, parenting, or other activities.

Choice D is wrong because identity vs role confusion is the fifth stage of Erikson’s theory, which occurs in adolescence.

It involves developing a stable and coherent sense of self and one’s role in society.

Normal ranges for Erikson’s stages are:.

• Trust vs mistrust: birth to 18 months.

• Autonomy vs shame and doubt: 18 months to 3 years.

• Initiative vs guilt: 3 to 6 years.

• Industry vs inferiority: 6 to 12 years.

• Identity vs role confusion: 12 to 18 years.

• Intimacy vs isolation: 18 to 40 years.

• Generativity vs stagnation: 40 to 65 years.

• Ego integrity vs despair: 65 years and older.

The correct answer isD.

All of the above.All of these findings are risk factors for falls in older adults, according to the literature.

Some explanations for why each choice is a risk factor are:.

A. Orthostatic hypotension: This is a condition where blood pressure drops too much when getting up from lying down or sitting, causing dizziness, lightheadedness, or fainting.This can affect balance and increase the chance of falling.

B. Urinary frequency: This is a condition where one needs to urinate often, sometimes urgently.This can cause rushed movement to the bathroom, especially at night, which can lead to tripping, slipping, or losing balance.

C. Visual impairment: This is a condition where one has reduced or distorted vision, such as due to cataracts, glaucoma, macular degeneration, or diabetic retinopathy.This can affect depth perception, contrast sensitivity, and ability to detect obstacles or hazards in the environment.

Some normal ranges for these conditions are:.

• Orthostatic hypotension: A normal blood pressure change when standing up is less than 20 mmHg systolic (top number) or 10 mmHg diastolic (bottom number).

Orthostatic hypotension is defined as a drop of at least 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.

• Urinary frequency: A normal urinary frequency is about 4 to 6 times per day, depending on fluid intake and other factors.

Urinary frequency is considered abnormal if it is more than 8 times per day or more than 2 times per night.

• Visual impairment: A normal visual acuity is 20/20 or better with or without correction.

Visual impairment is defined as a visual acuity of 20/40 or worse in the better-seeing eye with best correction possible.