Your second older adult female client has been experiencing some problems with urinary incontinence. You suggest that she document which of the following in a “bladder/voiding diary”? (Select all that apply.)

Choice A reason: Constipation is the nurse's priority for preventive care, as it is a common and serious side effect of morphine and other opioids, which can slow down the bowel movements and cause hard, dry stools. The nurse would advise the older adult to increase their fiber and fluid intake, use stool softeners or laxatives as prescribed, and report any signs of bowel obstruction, such as abdominal pain, bloating, nausea, or vomiting.

Choice B reason: Poor liquid intake is not the nurse's priority for preventive care, as it is not directly related to the use of morphine, although it can contribute to constipation and dehydration. The nurse would advise the older adult to drink enough fluids, unless they have a fluid restriction, and to monitor their urine output, color, and specific gravity.

Choice C reason: Diarrhea is not the nurse's priority for preventive care, as it is not a common side effect of morphine, although it can occur in some cases due to an allergic reaction, intolerance, or overdose. The nurse would advise the older adult to report any episodes of diarrhea, as it can cause dehydration, electrolyte imbalance, or malabsorption.

Choice D reason: Poor solid food intake is not the nurse's priority for preventive care, as it is not directly related to the use of morphine, although it can affect the nutritional status and wound healing of the older adult. The nurse would advise the older adult to eat a balanced diet that meets their caloric and protein needs, and to avoid foods that can cause gas, indigestion, or constipation.

Choice A reason: Scabies is a skin infestation caused by tiny mites that burrow into the skin and lay eggs. It causes intense itching and a pimple-like rash, usually in the folds of the skin, such as the armpits, groin, or between the fingers. Scabies is highly contagious and can spread through direct skin contact or shared clothing or bedding.

Choice B reason: Herpes zoster, also known as shingles, is a viral infection that affects the nerves and the skin. It causes a painful, blistering rash that usually appears on one side of the body or face. Herpes zoster is caused by the same virus that causes chickenpox, which can reactivate later in life, especially in older adults or people with weakened immune systems.

Choice C reason: Skin cancer is an abnormal growth of skin cells that can be caused by exposure to ultraviolet (UV) radiation from the sun or tanning beds. It can appear as a new or changing mole, a sore that does not heal, or a scaly or crusty patch of skin. Skin cancer can vary in appearance, size, shape, and color, depending on the type and stage of the cancer.

Choice D reason: Actinic keratosis is a precancerous skin condition that is caused by chronic sun damage. It appears as rough, scaly, or crusty spots on the skin, usually on the face, ears, scalp, or hands. Actinic keratosis can sometimes develop into squamous cell carcinoma, a type of skin cancer, if left untreated.