A nurse is caring for an older adult client who is at risk for skin breakdown. The nurse should use which of the following interventions to help maintain the integrity of the client's skin?
Reposition the client every 3 hours.
Apply cornstarch to keep the skin dry.
Provide the client with a diet high in protein.
Massage bony prominences to promote circulation.
The Correct Answer is C
A diet high in protein can help maintain skin integrity in older adults. Protein is essential for tissue repair and wound healing. The other options may not be as effective in maintaining skin integrity. For example, repositioning the client every 3 hours may not be frequent enough to prevent pressure ulcers. Applying cornstarch to keep the skin dry may not be the best option as it is important to keep the skin moisturized. Massaging bony prominences to promote circulation may not be recommended as it could cause damage to fragile skin.
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Related Questions
Correct Answer is A
Explanation
The nurse should instruct the client to include more whole grains in their diet and drink more water daily to improve their inconsistent fecal elimination pattern. Whole grains are high in fiber which can help regulate bowel movements and drinking more water can help keep stools soft and easy to pass ¹. Using enemas as desired is not a recommended solution for long-term management of inconsistent fecal elimination patterns. It is important for the client to consult with their healthcare provider for personalized advice and treatment options.
Correct Answer is A
Explanation
The nursing process consists of five phases: assessment, diagnosis, planning, implementation, and evaluation. During the assessment phase, the nurse gathers information about the client's health status and needs. In this scenario, the nurse is conducting a dressing change and notes a new area of skin breakdown. This observation is part of the assessment phase of the nursing process, as the nurse is gathering information about the client's condition. The other phases of the nursing process involve analyzing the information gathered during assessment (diagnosis), developing a plan of care (planning), carrying out interventions (implementation), and evaluating the effectiveness of care (evaluation).
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