A nurse is teaching a group of middle adult clients about osteoporosis. Which of the following risk factors should the nurse include?

Choice A rationale:

Severe headache can be a symptom of a subdural hematoma, but it is not the earliest manifestation of a change in neurological status. Other symptoms may appear before a severe headache, such as an altered level of consciousness.

Choice B rationale:

Bradycardia can occur with a subdural hematoma, especially as intracranial pressure increases. However, it is not the earliest manifestation of a change in neurological status. Changes in heart rate may occur later in the progression of the condition.

Choice C rationale:

Widened pulse pressure can also occur in patients with a subdural hematoma due to increased intracranial pressure. However, it is not the earliest manifestation of a change in neurological status. Other neurological signs would likely appear before changes in pulse pressure are evident.

Choice D rationale:

Change in level of consciousness is the earliest manifestation of a change in neurological status with a subdural hematoma. As intracranial pressure increases, the brain's functioning can be affected, leading to alterations in consciousness, ranging from mild confusion to unconsciousness.

Choice A rationale:

Prolonged sun exposure is a risk factor for osteoporosis because it can lead to vitamin D deficiency. Vitamin D is essential for calcium absorption, and low levels of vitamin D can contribute to reduced bone density and increased risk of fractures.

Choice B rationale:

Reduced intake of vitamin E is not a well-established risk factor for osteoporosis. Vitamin E is an antioxidant and plays a role in various bodily processes, but its association with osteoporosis is not supported by strong evidence.

Choice C rationale:

Drinking one glass of wine per day is not a risk factor for osteoporosis. In fact, moderate alcohol consumption has been suggested to have a protective effect on bone density in some studies.

Choice D rationale:

Exposure to second-hand tobacco smoke is a risk factor for osteoporosis. Smoking and exposure to tobacco smoke have been linked to decreased bone density and increased risk of fractures, making this an important point to include in the teaching.