A nurse is planning care for an older adult client who has dementia and a nutritional deficit.
Which of the following actions should the nurse plan to take?

Choice A rationale

Sitting in chairs with low, soft backs can worsen osteoarthritis symptoms and increase joint stress. Low chairs require more force from the hips and knees to stand up, which can strain these joints. Soft backs provide inadequate support, leading to poor posture and increased stress on the spine and other joints. Proper joint protection involves maintaining good posture and minimizing strain on affected joints.

Choice B rationale

Using both hands to hold objects distributes the weight and stress evenly across multiple joints, such as those in both wrists and hands, thereby reducing the workload on any single joint. This technique minimizes the risk of joint deformation and pain associated with osteoarthritis by preventing excessive force from being applied to a single joint, a key principle of joint protection.

Choice C rationale

Pushing up from a bed with fingers puts a concentrated, high-impact force on the small joints of the fingers, which are often affected by osteoarthritis. This action can lead to pain, inflammation, and potential deformity over time. Instead, individuals should use their palms or forearms to push up, distributing the force over a larger, stronger surface area.

Choice D rationale

Turning doorknobs clockwise or in any specific direction with a forceful grip can exacerbate joint pain and strain in the fingers and wrist. This motion places significant torque on the affected joints. To protect joints, clients should be advised to use lever-style doorknobs or adaptive devices that require less grip strength and a different motion. *.

Choice A rationale

Beginning ball-squeezing exercises is a correct instruction. These exercises, along with others like wall climbing, are essential to promote lymphatic drainage and restore range of motion in the arm on the affected side. Starting these early helps prevent the development of lymphedema, a common complication of mastectomy, by facilitating circulation and reducing fluid accumulation.

Choice B rationale

Wearing a bra with wire support is incorrect. Post-mastectomy, a client should be advised to wear a soft, supportive, and non-restrictive bra, preferably without underwire. Underwire can cause pressure and irritation on the incision site, potentially delaying healing and increasing the risk of lymphedema by compressing lymphatic vessels, which impedes the proper flow of lymph.

Choice C rationale

Avoiding using the affected arm for eating is incorrect. Gentle use of the affected arm for activities of daily living, such as eating and dressing, is encouraged early on to promote mobility and prevent stiffness. The key is to avoid strenuous activities and heavy lifting, but using the arm for routine tasks is beneficial for maintaining function and promoting recovery.

Choice D rationale

Using deodorant under the affected arm is incorrect. After a modified radical mastectomy, the client should be advised to avoid applying deodorant, lotions, or creams to the axilla on the surgical side. The skin in this area is often sensitive and prone to irritation, and these products can introduce bacteria, increasing the risk of infection and interfering with the healing process of the surgical site. .