The nurse is planning to instruct a group of adolescents on ways to prevent traumatic brain injuries. What should be included in these instructions?

Choice a reason:
Educational Prevention is not a recognized level of prevention in healthcare. While education is a key component in all levels of prevention, it is not a standalone category. Education is typically included in primary prevention as it involves informing the public about health practices to prevent the onset of disease.

Choice b reason:
Tertiary Prevention is the level of prevention that aims to manage and treat an existing disease to prevent further complications or deterioration. In the case of immobile stroke patients, tertiary prevention would involve measures to prevent skin breakdown and other complications associated with immobility and the stroke's long-term effects.

Choice c reason:
Secondary Prevention involves early detection and prompt intervention to prevent the progression of a disease. For stroke patients, secondary prevention might include monitoring for signs of skin breakdown so that early treatment can be initiated. However, the scenario described focuses on managing an existing condition rather than early detection.

Choice d reason:
Primary Prevention aims to prevent the disease or injury before it occurs. This would involve strategies to prevent strokes in the first place, such as controlling high blood pressure or encouraging healthy lifestyle changes. It does not directly relate to the prevention of skin breakdown in patients who have already had a stroke.

Choice a reason:
The oral mucosa is the most reliable area to evaluate for central cyanosis in a client with asthma. Central cyanosis reflects a decrease in arterial oxygenation and is best assessed where the blood flow is high and the skin is thin, which is the case with the oral mucosa. It is less likely to be affected by peripheral factors such as temperature and is therefore a more accurate indicator of oxygen saturation in the central circulation.

Choice b reason:
While ear lobes can show signs of cyanosis, they are not the most reliable indicator of central cyanosis because they are more prone to peripheral cyanosis. Peripheral cyanosis can occur in the ear lobes due to local vasoconstriction or decreased blood flow, which may not reflect central oxygenation levels.

Choice c reason:
The soles of the feet are not a reliable indicator of central cyanosis, especially in a client with asthma. The skin on the soles is thicker and has less blood flow compared to the oral mucosa, making it a poor site for assessing central cyanosis. Additionally, the soles can be affected by peripheral factors like pressure and temperature.

Choice d reason:
Conjunctivae are not the most reliable indicator of central cyanosis. While they can show signs of cyanosis, the assessment can be affected by environmental factors and the presence of blood vessels in the conjunctiva that may not accurately reflect central oxygenation levels.