A nurse is reinforcing discharge teaching with an older adult client's family about safety precautions when administering a tap water enema to the client. Which of the following should the nurse include in the instructions?

Answer: B

Rationale:

A) Use written signs to assist the client with locating the bathroom: While written signs may be helpful in the earlier stages of Alzheimer's disease, as the disease progresses, clients may lose the ability to read and comprehend written language. Visual cues, such as pictures or color-coded indicators, tend to be more effective in helping clients navigate their environment.

B) Limit the number of choices for the client: Limiting choices reduces confusion and anxiety for clients with Alzheimer's disease. Providing too many options can overwhelm them, making decision-making difficult. Offering simple, clear choices helps to maintain a sense of autonomy while minimizing stress.

C) Provide a stimulating environment for the client: Although some stimulation can be beneficial, excessive stimulation can overwhelm a client with Alzheimer's disease, leading to agitation and confusion. It's important to create a calm, structured environment that promotes safety and reduces anxiety.

D) Use confrontation to manage the client’s behavior: Confrontation should be avoided when managing the behavior of clients with Alzheimer's disease. Confronting or challenging them can increase agitation and lead to further confusion. Instead, caregivers should use distraction, redirection, and a calm approach to manage difficult behaviors effectively.

Neisseria gonorrhoeae is the bacterium responsible for the sexually transmitted infection known as gonorrhea. Gonorrhea is a reportable communicable disease, meaning healthcare providers are required to report cases to the appropriate public health authorities. This allows for tracking and monitoring of the disease, implementation of appropriate public health measures, and prevention of further spread of the infection.

Sarcoptes scabiei: This refers to scabies, a parasitic infestation caused by mites. While scabies can be contagious, it is not typically a reportable disease to the state health department.

Impetigo contagiosa: Impetigo is a bacterial skin infection that can be caused by various bacteria, including Staphylococcus aureus and Streptococcus pyogenes. Although it is contagious, it is not typically a reportable disease to the state health department.

Human papillomavirus (HPV): HPV is a viral infection transmitted through sexual contact. While it is a significant public health concern due to its association with cervical cancer and other conditions, it is not usually a reportable disease to the state health department. However, certain states may have specific reporting requirements for HPV-related diseases or conditions, such as cervical cancer. It is important to be familiar with the specific reporting guidelines of the state in question.