An 82-year-old diabetic client is being treated in the hospital for a sacral pressure ulcer. What age-related change is most likely to affect the client's course of treatment?

A. Client with restricted activity - Patients with limited mobility are at a higher risk for pressure ulcers because they are unable to change positions easily, leading to prolonged pressure on certain body parts.

B. Client who can ambulate - Patients who can ambulate have the ability to shift their body weight and change positions, reducing the risk of prolonged pressure on specific areas. Ambulation can improve circulation and reduce the risk of pressure ulcers

C. Client with a cast - Clients with casts are often limited in their ability to move or change positions, making them susceptible to pressure ulcers in areas where the cast creates pressure points on the skin.

D. Client with good nutrition - Proper nutrition is essential for overall health, including skin health. Adequate nutrition promotes wound healing and tissue repair. Good nutrition is not a risk factor for pressure ulcers; in fact, it can contribute to preventing them by maintaining healthy skin.
E. Client with urinary and fecal incontinence - Incontinence can lead to moisture on the skin, making it more susceptible to breakdown. Prolonged exposure to moisture, especially in the presence of urine or feces, can increase the risk of pressure ulcer development.

A. Inadequate immobilization: Proper immobilization is essential for fractured bones to heal correctly. Immobilization, often achieved through casts, splints, or other orthopedic devices, stabilizes the broken bone fragments, allowing them to fuse back together. If the immobilization is not sufficient or if the patient doesn't follow the prescribed immobilization protocol, there can be excessive movement at the fracture site, hindering the healing process.

B. Venous thromboembolism: Venous thromboembolism (VTE) refers to the formation of blood clots in veins, usually in the legs (deep vein thrombosis) that can travel to the lungs (pulmonary embolism). While VTE is a potential complication after a fracture, it is not a direct cause of delayed bone union.

C. Inadequate vitamin D intake: Vitamin D is essential for bone health as it helps the body absorb calcium, which is crucial for bone formation and maintenance. Inadequate vitamin D levels can weaken bones and impair the healing process, but it's not a common cause of delayed bone union unless there are severe deficiencies or underlying medical conditions.

D. Bleeding at the injury site: Bleeding at the injury site occurs immediately after the fracture and is a natural part of the body's response to injury. While excessive bleeding can lead to complications, it is not a likely cause of delayed bone union six weeks after the injury. In the early stages of healing, bleeding is replaced by the formation of a hematoma, which eventually transforms into a callus and aids in the bone healing process.