An older adult diagnosed with moderate dementia is seen in the geriatric clinic. As the nurse is evaluating the client, the client's wife states that her husband has developed an increasing number of episodes of incontinence. She does not know what is precipitating the episodes, and states "maybe he just doesn't remember that he needs to urinate or maybe it's me, it takes me a while to walk him to the bathroom." The nurse develops a plan of care for this client and includes which of the following interventions to manage the incontinence? (Select all that apply.)

Choice A reason: Having stable vital signs does not necessarily mean that the client is not experiencing pain. Vital signs can be affected by various factors, such as medications, stress, or emotions, and may not reflect the true level of pain.

Choice B reason: Holding abdomen tightly is a possible sign of pain, especially if the client had abdominal surgery or has a condition that affects the digestive system. The client may be guarding the painful area or trying to relieve the discomfort.

Choice C reason: Not verbalizing is not a reliable indicator of pain, especially for clients with dementia who may have difficulty communicating or expressing their feelings. The nurse should look for other cues, such as facial expressions, body language, or behavioral changes, to assess the client's pain.

Choice D reason: Moving during sleep is not a specific sign of pain, and may be normal for some clients. However, if the client is restless, agitated, or moaning during sleep, it may indicate that the client is in pain and needs intervention.

Choice A reason: Squamous cell carcinoma is a type of skin cancer that develops from the squamous cells that make up the outer layer of the skin. It usually appears as a scaly, red, or crusty patch or lump that may bleed or ulcerate. It is the second most common type of skin cancer, after basal cell carcinoma, but it is less common than melanoma.

Choice B reason: Actinic keratosis is a skin condition that causes rough, scaly, or crusty patches or spots on the skin that are usually caused by sun exposure. It is not a type of skin cancer, but it is considered a precancerous lesion, as it can sometimes develop into squamous cell carcinoma if left untreated.

Choice C reason: Kaposi sarcoma is a rare type of skin cancer that causes purple, red, or brown patches or nodules on the skin or mucous membranes. It is caused by a virus called human herpesvirus 8 (HHV-8), and it mainly affects people with weakened immune systems, such as those with HIV/AIDS or organ transplants.

Choice D reason: Melanoma is a type of skin cancer that develops from the melanocytes, the cells that produce the pigment melanin that gives the skin its color. It usually appears as a mole or a new or changing spot on the skin that may have an irregular shape, color, or border. It is the most common type of skin cancer, and also the most serious, as it can spread to other parts of the body if not detected and treated early.