The nurse notes that an elderly client has a history of osteoporosis. What safety measure should the nurse prioritize for this client?

Choice A reason: Tachycardia is a physiological response to fear and anxiety. Tachycardia is a condition where the heart rate is faster than normal, usually above 100 beats per minute. Fear and anxiety can trigger the release of stress hormones, such as adrenaline and cortisol, that stimulate the sympathetic nervous system. This causes the heart to beat faster and stronger, increasing the blood flow and oxygen delivery to the muscles and organs. This prepares the body for the fight-or-flight response, which is a survival mechanism that helps the person to cope with a perceived threat or danger.

Choice B reason: Bronchial constriction is not a physiological response to fear and anxiety. Bronchial constriction is a condition where the airways in the lungs become narrow and inflamed, reducing the airflow and causing difficulty breathing. Bronchial constriction can be caused by various factors, such as asthma, allergies, infections, or irritants. Fear and anxiety can worsen the symptoms of bronchial constriction, but they are not the primary cause of it.

Choice C reason: Bradypnea is not a physiological response to fear and anxiety. Bradypnea is a condition where the breathing rate is slower than normal, usually below 12 breaths per minute. Bradypnea can be caused by various factors, such as brain injury, drug overdose, sleep apnea, or metabolic disorders. Fear and anxiety can increase the breathing rate, not decrease it, as the body needs more oxygen to cope with the stress.

Choice D reason: Pupillary constriction is not a physiological response to fear and anxiety. Pupillary constriction is a condition where the pupils in the eyes become smaller and less responsive to light. Pupillary constriction can be caused by various factors, such as eye injury, medication, aging, or neurological disorders. Fear and anxiety can cause pupillary dilation, not constriction, as the pupils widen to allow more light and improve the vision. This helps the person to see better and react faster to the situation.

Choice A reason: Utilize supine positioning to maximize chest expansion is not an important intervention for clients with a BMI greater than or equal to 30. Supine positioning is when the client lies flat on their back. This position can actually impair chest expansion and breathing for clients with a high BMI, as the weight of the abdomen and chest can compress the lungs and diaphragm. A semi-Fowler's position, where the head of the bed is elevated at 30 to 45 degrees, is preferred for these clients, as it reduces the pressure on the chest and improves ventilation.

Choice B reason: Use an appropriately sized blood pressure cuff is an important intervention for clients with a BMI greater than or equal to 30. A blood pressure cuff that is too small or too tight can cause inaccurate readings and increase the risk of injury to the client. A blood pressure cuff that is too large or too loose can also cause inaccurate readings and compromise the quality of care. A blood pressure cuff that fits the client's arm circumference and width is essential for obtaining accurate and reliable measurements and preventing complications.

Choice C reason: Consult a nutritionist because the client is malnourished/underweight is not an important intervention for clients with a BMI greater than or equal to 30. A BMI greater than or equal to 30 indicates that the client is obese, not malnourished or underweight. Obesity is a condition where the client has excess body fat that can affect their health and well-being. Malnutrition is a condition where the client has inadequate or imbalanced intake of nutrients that can affect their growth and development. Underweight is a condition where the client has a low body weight that can affect their immunity and energy. A nutritionist can help clients with any of these conditions, but the statement is incorrect for clients with a high BMI.

Choice D reason: Place the client on fall precautions because of increased risk for falls due to frail bones is not an important intervention for clients with a BMI greater than or equal to 30. Frail bones are not a common consequence of obesity, but rather of osteoporosis, a condition where the bones become weak and brittle. Obesity can actually increase the bone density and strength, as the bones have to support more weight. However, obesity can increase the risk for falls due to other factors, such as impaired mobility, balance, or coordination. Fall precautions are important for any client who is at risk for falls, but the statement is inaccurate for clients with a high BMI.