A new nurse in a long-term care facility is caring for a client diagnosed with Parkinson's disease (PD). The nurse should note that which one of the following actions is likely to be observed during the assessment?

Choice A reason: Controlling fluid balance is the most important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as fluid overload is the main cause of HF worsening and hospital admission. Fluid balance can be controlled by monitoring weight, intake and output, edema, and lung sounds, and by administering diuretics, restricting sodium and fluid intake, and elevating the legs.

Choice B reason: Controlling blood pressure is an important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as hypertension is a risk factor and a complication of HF. However, it is not the most important goal, as blood pressure may not always reflect the fluid status or the severity of HF. Blood pressure can be controlled by administering antihypertensive medications, such as angiotensin-converting enzyme inhibitors, beta-blockers, or calcium channel blockers, and by encouraging lifestyle modifications, such as smoking cessation, weight management, and stress reduction.

Choice C reason: Preventing deconditioning is an important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as deconditioning is a common problem in HF patients due to reduced physical activity, fatigue, and muscle wasting. However, it is not the most important goal, as deconditioning may not directly affect the fluid balance or the cardiac function. Deconditioning can be prevented by providing exercise training, such as aerobic, resistance, or interval training, and by promoting self-care and adherence to the treatment regimen.

Choice D reason: Maintaining client safety is an important goal in the nursing plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults, as HF patients are at risk of falls, injuries, infections, or adverse drug reactions. However, it is not the most important goal, as client safety may not specifically address the fluid balance or the cardiac function. Client safety can be maintained by providing a safe environment, such as removing clutter, providing adequate lighting, and using assistive devices, and by preventing complications, such as monitoring for signs of infection, bleeding, or electrolyte imbalance, and by educating the client and the family about the medications, the signs and symptoms of HF worsening, and the emergency measures.

Choice A reason: This is incorrect because issues related to the digestive system are not likely to be caused by UTIs or constipation. Digestive system issues can include gastritis, ulcers, irritable bowel syndrome, or inflammatory bowel disease, which can cause symptoms such as abdominal pain, nausea, vomiting, diarrhea, or bleeding. These symptoms are different from UTIs or constipation, which affect the urinary and bowel functions, respectively.

Choice B reason: This is incorrect because vitamin B12 deficiency is not likely to be caused by UTIs or constipation. Vitamin B12 deficiency can occur due to poor dietary intake, malabsorption, or pernicious anemia, which can cause symptoms such as fatigue, weakness, numbness, tingling, or anemia. These symptoms are different from UTIs or constipation, which affect the urinary and bowel functions, respectively.

Choice C reason: This is incorrect because malnutrition is not likely to be caused by UTIs or constipation. Malnutrition can occur due to inadequate food intake, poor food quality, or increased nutritional needs, which can cause symptoms such as weight loss, muscle wasting, edema, or poor wound healing. These symptoms are different from UTIs or constipation, which affect the urinary and bowel functions, respectively.

Choice D reason: This is correct because dehydration can be caused by UTIs or constipation. UTIs can cause increased urination, fever, or vomiting, which can lead to fluid loss and dehydration. Constipation can cause reduced fluid intake, hard stools, or straining, which can also lead to fluid loss and dehydration. Dehydration can cause symptoms such as dry mouth, thirst, low urine output, dark urine, or low blood pressure. Dehydration can also worsen UTIs or constipation, creating a vicious cycle. Therefore, dehydration is a possible condition that the client might be suffering from.