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 D.

Report any signs of infection or delayed wound healing.

This is because oral hypoglycemic agents lower the blood glucose level, but they do not prevent the complications of diabetes mellitus, such as impaired wound healing and increased susceptibility to infections.Therefore, the client should be advised to monitor for any signs of infection, such as fever, redness, swelling, or pus, and report them to the health care provider promptly.

Choice A is wrong because checking blood glucose levels at least four times a day is not necessary for most clients who are taking oral hypoglycemic agents.

The frequency of blood glucose monitoring depends on the type and dose of medication, the level of glycemic control, and the presence of other factors that may affect blood glucose, such as illness or stress.The client should follow the individualized plan prescribed by the health care provider regarding blood glucose monitoring.

Choice B is wrong because drinking plenty of fluids and avoiding caffeine is not specific to clients who are taking oral hypoglycemic agents.

This is a general recommendation for all clients who have diabetes mellitus, as dehydration and caffeine can worsen hyperglycemia and increase the risk of diabetic ketoacidosis or hyperosmolar hyperglycemic state.However, this alone is not sufficient to manage diabetes mellitus and prevent complications.

Choice C is wrong because eating small, frequent meals and avoiding simple sugars is also a general recommendation for all clients who have diabetes mellitus, as this can help to maintain a stable blood glucose level and prevent hypoglycemia or hyperglycemia.

However, this alone is not sufficient to manage diabetes mellitus and prevent complications.The client should also follow a balanced diet that includes complex carbohydrates, protein, fiber, and healthy fats, and consult with a dietitian or a diabetes educator for individualized dietary guidance.

The correct answer isD.

All of the above.

The nurse should take all of the actions listed to provide effective pain management for the older adult client who has depression and chronic pain in his lower back.

• Choice Ais correct because assessing the pain using a valid and reliable pain scale is essential for determining the severity and impact of pain, as well as monitoring the response to treatment.

• Choice Bis correct because administering analgesic medications as prescribed can help reduce pain and improve function.

The nurse should also monitor for effectiveness and side effects, especially in older adults who may have altered drug metabolism, polypharmacy, and increased risk of adverse events.

• Choice Cis correct because providing non-pharmacological interventions can enhance pain relief, reduce medication use, and address the biopsychosocial aspects of pain.

Massage, heat or cold therapy, relaxation techniques, and distraction are some examples of non-pharmacological interventions that can be used for chronic pain in older adults.

• Choice Dis correct because it includes all of the above actions, which are part of a multimodal approach to pain management that is recommended by clinical guidelines.

4 7 A multimodal approach can improve pain outcomes, reduce side effects, and address the complex needs of older adults with chronic pain.

A. Assess the location, intensity, quality and duration of the pain using a pain scale B.

Administer analgesic medications as prescribed and monitor for effectiveness and side effects C.

Provide non-pharmacological interventions such as massage, heat or cold therapy, relaxation techniques or distraction D.

All of the above