A middle-aged client presents for an annual health visit at a community clinic. The client is 5 feet 10 inches (177.8 cm) tall, weighs 250 pounds (113.4 kg), and works as an accountant. The client has smoked at least one pack of cigarettes every day for the last 15 years. Which secondary prevention measure should the nurse recommend the client to follow?

A. Glaucoma:
Glaucoma is generally a concern for older adults rather than preschool-aged children. Screening for glaucoma typically starts later in life when the risk for this condition increases.

B. Red light reflex:
The red light reflex test is used primarily in infants and very young children to screen for conditions such as cataracts and retinoblastoma. While important, it is not usually the primary focus of annual screenings in preschool settings, which typically emphasize visual acuity.

C. Visual acuity:
Visual acuity screening is crucial for preschool-aged children to identify any issues with vision that could affect their development and learning. It helps detect problems like amblyopia (lazy eye) or refractive errors that need early intervention.

D. Conjunctivitis:
Conjunctivitis, or pink eye, is a common condition but is not typically part of routine annual eye health screenings. It is more relevant to address conjunctivitis as it arises rather than as part of an annual screening program.

A) Smoking cessation:
Smoking cessation is a crucial preventive measure and is considered a primary prevention strategy to reduce the risk of developing smoking-related diseases. However, for a middle-aged client who already has health issues such as obesity or hypertension, secondary prevention focuses on early detection and management of conditions that have already developed or are at high risk of developing.

B) Compliance with antihypertensive and lipid-lowering agents:
While compliance with medication is essential for managing existing conditions such as hypertension or dyslipidemia, it is not a secondary prevention measure in itself. Secondary prevention is focused on screening and early detection of health issues before they progress further.

C) Blood pressure and lipid screening:
Blood pressure and lipid screening are appropriate secondary prevention measures for this client. Secondary prevention involves identifying and managing health conditions early to prevent progression or complications. Given the client’s smoking history, weight, and potential risk for cardiovascular issues, regular screening for blood pressure and lipid levels helps detect any developing issues early, allowing for timely intervention.

D) Increase physical activity and diet low in saturated fat:
Increasing physical activity and adopting a diet low in saturated fat are important lifestyle changes for overall health and primary prevention of chronic diseases. However, in the context of secondary prevention, where the focus is on monitoring and managing existing risk factors or health conditions, screening measures like blood pressure and lipid testing are more directly relevant.