An older adult client had hip replacement surgery 1 day ago, and the nurse thinks that the client is also demonstrating dementia. Which client assessment does the nurse use to determine whether this client is experiencing pain?

Choice A reason: Altering modifiable risk factors is a good goal for anyone who wants to improve their health and wellness, but it is not specific to the case of the African American man who already has a normal blood pressure and no apparent health problems. Modifiable risk factors are those that can be changed by lifestyle choices, such as smoking, diet, exercise, stress, or alcohol consumption.

Choice B reason: Maintaining tight glycemic control is a relevant goal for people who have diabetes or prediabetes, as it can help prevent or delay the complications of high blood sugar, such as nerve damage, kidney damage, or eye damage. However, there is no indication that the African American man has diabetes or prediabetes, so this goal is not applicable to him.

Choice C reason: Recognizing disease in its early stages is a general goal for everyone who wants to prevent or treat health problems, but it is not specific to the case of the African American man who has no signs or symptoms of any disease. Moreover, this goal is more reactive than proactive, as it implies waiting for disease to occur rather than preventing it.

Choice D reason: Preventing cardiovascular disease is the best goal for the nurse to use to assist the African American man in maintaining his health and wellness into older age, as it is specific, proactive, and evidence-based. According to the American Heart Association, high blood pressure is a major risk factor for cardiovascular disease, and it is more prevalent and severe among African Americans than other racial groups. Therefore, the nurse would advise the African American man to monitor his blood pressure regularly, follow a healthy diet, exercise moderately, avoid smoking, and take medication if needed to prevent cardiovascular disease.

Choice A reason: Allergies to dairy are not commonly associated with the development of cardiovascular comorbidities for those diagnosed with type 2 diabetes, as they do not directly affect the blood glucose levels, blood pressure, or cholesterol levels. However, allergies to dairy may limit the dietary choices and nutritional intake of some individuals with type 2 diabetes.

Choice B reason: History of hypothyroidism is not commonly associated with the development of cardiovascular comorbidities for those diagnosed with type 2 diabetes, as it does not cause insulin resistance, hyperglycemia, or inflammation. However, hypothyroidism may increase the risk of obesity, dyslipidemia, and hypertension, which are risk factors for cardiovascular disease.

Choice C reason: Alcohol use is commonly associated with the development of cardiovascular comorbidities for those diagnosed with type 2 diabetes, as it can affect the blood glucose levels, blood pressure, and cholesterol levels. Alcohol can also interfere with the action of insulin and oral diabetes medications, increase the appetite and calorie intake, and damage the liver and pancreas.

Choice D reason: Chronic constipation is not commonly associated with the development of cardiovascular comorbidities for those diagnosed with type 2 diabetes, as it does not directly impact the blood glucose levels, blood pressure, or cholesterol levels. However, chronic constipation may indicate poor dietary habits, dehydration, or medication side effects, which may affect the overall health and well-being of individuals with type 2 diabetes.

Choice E reason: None of the above is not the correct answer, as there is one choice that is commonly associated with the development of cardiovascular comorbidities for those diagnosed with type 2 diabetes.