A gerontological nurse in a long-term care facility is implementing practices to provide quality, cost-effective care. Which action would be appropriate for the nurse?

A. Arrange a family meeting to organize supervision for the client:

This option focuses on organizing supervision for the client, assuming that the client requires constant monitoring to prevent falls. While involving family members in the care plan is important, arranging a family meeting might not be the priority until the nurse understands the client's perspective on the falls and explores potential solutions.

B. Elicit what the client perceives to be the causes of and potential solutions to the falls:

This option prioritizes communication with the client to understand their perspective on the falls, including what factors they believe contributed to the falls and what solutions they envision. It respects the client's autonomy and allows them to actively participate in their care planning, which can lead to more effective fall prevention strategies.

C. Investigate what community resources may be appropriate and available:

While community resources can be valuable for supporting older adults, investigating them may not be the priority until the nurse has assessed the client's specific needs and preferences regarding fall prevention. Understanding the client's perspective and potential solutions should come first to tailor the use of community resources accordingly.

D. Perform a comprehensive musculoskeletal assessment of the client:

While assessing musculoskeletal status is important for understanding factors that could contribute to falls, conducting a comprehensive assessment may not be the immediate priority. Instead, focusing on communication with the client to understand their perspective and potential solutions should come first to inform the assessment and subsequent interventions effectively.

A. Cultural factors:

Cultural factors can influence sleep patterns and behaviors, such as bedtime routines, sleep hygiene practices, and beliefs about sleep. However, in this scenario where the client's reported sleep disturbance is directly linked to a recent leg injury, cultural factors might have less direct relevance compared to other factors like pain or medications.

B. Level of pain:

Pain is a common cause of insomnia, particularly in cases where there is a recent injury. Pain can make it difficult for individuals to find a comfortable sleeping position or to relax enough to fall asleep. Assessing the level and nature of pain is crucial in addressing sleep disturbances in this context.

C. Eating habits:

While eating habits can influence overall health and well-being, they might have less immediate impact on sleep disturbances related to a recent leg injury. However, certain dietary factors, such as consuming caffeine or heavy meals close to bedtime, could exacerbate insomnia. It's still important to consider eating habits as part of a comprehensive assessment, but they might not be the primary focus in this scenario.

D. Expectations for recovery:

The client's expectations for recovery can influence their emotional state and overall psychological well-being, which in turn can impact sleep patterns. Anxiety, uncertainty, or unrealistic expectations about recovery may lead to increased stress and difficulty sleeping. Assessing the client's expectations and addressing any concerns or misconceptions can be essential in managing insomnia related to a recent injury.

E. Medications that could interfere with sleep:

Certain medications, such as pain relievers, muscle relaxants, or steroids prescribed for managing the leg injury, may have side effects that interfere with sleep. It's important to review the client's medication regimen to identify any potential sleep-disrupting drugs and consider adjustments or alternative medications if appropriate.