Which nursing diagnosis takes priority for a client who is receiving chemotherapy treatment for cancer?

Choice A is wrong because women are more at risk for hip fractures than men.

This is partly because women lose bone density faster than men do, especially after menopause.

Choice C is wrong because an increase in estrogen will not weaken the bones. In fact, estrogen helps protect the bones from osteoporosis, which is a leading cause of hip fracture.

Some other risk factors for hip fracture include:

• Excessive alcohol and caffeine consumption
• Lack of physical activity
• Low body weight
• Tall stature
• Vision problems
• Dementia
• Medications that cause bone loss
• Cigarette smoking
• Institutional living, such as an assisted-care facility
• Increased risk for falls, related to conditions such as weakness, disability, or unsteady gait

Normal ranges for bone density vary by age and sex, but generally, a T-score of -1.0 or above is considered normal, while a T-score of -2.5 or below is considered osteoporotic. A T-score between -1.0 and -2.5 is considered osteopenic, which means low bone mass.

“I have limited my alcohol intake before bedtime.”. This statement shows that the client understands that alcohol can interfere with sleep quality and quantity. Alcohol can disrupt the normal sleep cycle and cause frequent awakenings, nightmares, or insomnia.

Choice A is wrong because sleeping in most mornings can disrupt the regular sleep schedule and make it harder to fall asleep at night. It is better to keep a consistent bedtime and wake time, even on weekends.

Choice B is wrong because working on the computer before going to bed can expose the client to blue light, which can suppress the production of melatonin, a hormone that regulates sleep. It is better to avoid screens and other stimulating activities at least an hour before bedtime.

Choice D is wrong because watching television for 1 hour before sleeping can also expose the client to blue light and interfere with sleep onset. It is better to engage in relaxing activities such as reading, listening to soothing music, or meditating before sleeping.