A nurse is conducting education on urinary incontinence at a senior center. The nurse is discussing lifestyle changes that are associated with an improvement in urinary incontinence. The nurse includes which of the following interventions? (Select all that apply.)

Choice A reason: Squamous cell carcinoma is a type of skin cancer that develops from the squamous cells that make up the outer layer of the skin. It usually appears as a scaly, red, or crusty patch or lump that may bleed or ulcerate. It is the second most common type of skin cancer, after basal cell carcinoma, but it is less common than melanoma.

Choice B reason: Actinic keratosis is a skin condition that causes rough, scaly, or crusty patches or spots on the skin that are usually caused by sun exposure. It is not a type of skin cancer, but it is considered a precancerous lesion, as it can sometimes develop into squamous cell carcinoma if left untreated.

Choice C reason: Kaposi sarcoma is a rare type of skin cancer that causes purple, red, or brown patches or nodules on the skin or mucous membranes. It is caused by a virus called human herpesvirus 8 (HHV-8), and it mainly affects people with weakened immune systems, such as those with HIV/AIDS or organ transplants.

Choice D reason: Melanoma is a type of skin cancer that develops from the melanocytes, the cells that produce the pigment melanin that gives the skin its color. It usually appears as a mole or a new or changing spot on the skin that may have an irregular shape, color, or border. It is the most common type of skin cancer, and also the most serious, as it can spread to other parts of the body if not detected and treated early.

Choice A reason: This is incorrect because using smooth muscle relaxants is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Smooth muscle relaxants are medications that can relax the bladder and reduce the urge to urinate, but they can also cause side effects such as dry mouth, constipation, or blurred vision. They are not suitable for all types of urinary incontinence, and they should be used with caution and under medical supervision.

Choice B reason: This is incorrect because availability of protective rubber garments is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Protective rubber garments are devices that can prevent urine leakage and protect the skin and clothing, but they can also cause skin irritation, infection, or odor. They are not a cure for urinary incontinence, and they should be used as a last resort or in combination with other interventions.

Choice C reason: This is incorrect because using indwelling urinary catheters is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Indwelling urinary catheters are tubes that can drain urine from the bladder and collect it in a bag, but they can also cause complications such as urinary tract infections, bladder spasms, or trauma. They are not recommended for long-term use, and they should be used only when other methods have failed or are contraindicated.

Choice D reason: This is correct because maintaining an attitude that is respectful and positive about resolving the problem is the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Urinary incontinence can cause embarrassment, shame, isolation, or depression in older clients, and they may be reluctant to seek help or comply with treatment. The nurse should respect the client's dignity, privacy, and preferences, and provide education, support, and encouragement. The nurse should also assess the underlying causes and contributing factors of urinary incontinence, and implement individualized and evidence-based interventions.