An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around-the-clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? (Select all that apply.)

Choice A reason: This statement is incorrect because the zoster vaccine Shingrix can be given to individuals who have had a previous episode of Herpes Zoster (HZ), as long as they are not currently experiencing an acute outbreak. The vaccine can help prevent future recurrences of HZ, as well as reduce the risk of postherpetic neuralgia, a painful complication of HZ.
Choice B reason: This statement is correct because the zoster vaccine Shingrix is recommended for all individuals over age 50 that have no contraindications to the vaccine, such as a history of severe allergic reaction to any component of the vaccine, or a current severe immunodeficiency. The vaccine can help prevent HZ and its complications, which are more common and severe in older adults.
Choice C reason: This statement is incorrect because the zoster vaccine Shingrix can be given to individuals with a chronic cardiac or respiratory condition, as long as they are not immunocompromised. The vaccine is not a live vaccine, so it does not pose a risk of causing or worsening the underlying condition. The vaccine can help protect the individuals from HZ and its complications, which can exacerbate their condition or interfere with their treatment.
Choice D reason: This statement is incorrect because the zoster vaccine Shingrix does not always prevent an individual from developing Herpes Zoster. The vaccine has a high efficacy rate of about 90%, but it is not 100%. The vaccine can reduce the severity and duration of HZ, as well as the risk of postherpetic neuralgia, if it does occur.

Choice A reason: Wearing well-fitting shoes is a good intervention for the older adult man to reduce his discomfort, as it can prevent pressure, friction, or injury to his feet, which can worsen the burning sensation. The nurse would advise the older adult man to choose shoes that are comfortable, supportive, and breathable, and to avoid shoes that are too tight, too loose, or have high heels or pointed toes.

Choice B reason: Soaking the feet in warm water is not a recommended intervention for the older adult man to reduce his discomfort, as it can dry out his skin, increase the risk of infection, or cause thermal injury if the water is too hot. The nurse would advise the older adult man to wash his feet daily with mild soap and lukewarm water, and to dry them thoroughly, especially between the toes.

Choice C reason: Applying antifungal powder on the feet is not a necessary intervention for the older adult man to reduce his discomfort, unless he has a fungal infection, such as athlete's foot, which can cause itching, burning, or cracking of the skin. The nurse would advise the older adult man to check his feet regularly for any signs of infection, such as redness, swelling, or pus, and to seek medical attention if he has any.

Choice D reason: Wearing knee-high nylon stockings is not a helpful intervention for the older adult man to reduce his discomfort, as it can impair his blood circulation, trap moisture, or irritate his skin. The nurse would advise the older adult man to wear socks that are made of cotton or wool, and to change them daily or whenever they are wet or dirty.