A nurse is assessing an older adult client who reports feeling lonely and isolated since retiring from work.

Which of the following questions should the nurse ask to assess the client’s psychosocial changes?

The correct answer is A.

How do you spend your time during the day?.

This question is relevant to assess the client’s psychosocial changes because it can reveal the client’s level of activity, engagement, and satisfaction with their daily routine.Older adults may face various psychosocial challenges that can affect their well-being and social relationships, such as isolation, loss of identity, mistrust, guilt, and financial anxiety.

Asking about the client’s daily activities can help the nurse identify any signs of depression, anxiety, loneliness, boredom, or cognitive impairment that may require further intervention.

Choice B is wrong because it is not directly related to the client’s psychosocial changes.

Asking about hobbies or interests may provide some information about the client’s personality and preferences, but it does not address the client’s current emotional or social state.

Choice C is wrong because it is too specific and may not capture the full extent of the client’s social network and support.

Asking about friends or family members may indicate the client’s level of connectedness and attachment, but it does not explore the quality or frequency of those relationships.

Choice D is wrong because it is too broad and may not elicit useful information for the nurse.

Asking about coping strategies may be helpful to assess the client’s resilience and adaptability, but it does not focus on the client’s present psychosocial issues or needs.

Normal ranges for psychosocial changes in older adults are difficult to define, as they depend on various factors such as culture, personality, life experiences, health status, and environmental conditions.However, some general indicators of healthy psychosocial functioning in older adults include:.

• Having a positive self-image and a sense of purpose.

• Maintaining social contacts and meaningful relationships.

• Engaging in enjoyable and stimulating activities.

• Expressing emotions appropriately and seeking help when needed.

• Accepting changes and losses with grace and dignity.

• Demonstrating wisdom and integrity.

The correct answer is B.

“You have done a great job managing your blood sugar levels and taking your medications.” This statement supports the dignity, autonomy and quality of life of the client by acknowledging their efforts and achievements in managing their chronic conditions.

It also reinforces positive behaviors and encourages self-care.

Choice A is wrong because it expresses pity and sympathy, which can undermine the client’s dignity and self-esteem.

It also does not address the client’s depression or hearing loss.

Choice C is wrong because it implies that the client is not doing enough to cope with their depression and hearing loss.

It also does not respect the client’s preferences and choices regarding their social activities.

Choice D is wrong because it is too directive and does not consider the client’s autonomy or reasons for not wearing their hearing aid.

It also does not address the client’s diabetes or depression.

Some of the nursing interventions for an older adult client who has diabetes, depression and hearing loss are:.

• Assessing the client’s physical, mental, emotional, social, and spiritual needs and providing individualized care.

• Promoting safety and preventing falls and injuries by removing environmental hazards, providing assistive devices, and educating the client on fall prevention strategies.

• Improving gas exchange and respiratory function by monitoring vital signs, oxygen saturation, breath sounds, and respiratory symptoms; administering oxygen therapy as prescribed; encouraging deep breathing and coughing exercises; and promoting hydration.

• Managing hypothermia by monitoring temperature, skin color, and sensation; providing warm clothing, blankets, and fluids; and avoiding exposure to cold environments.

• Promoting adequate sleep and improving sleep patterns by assessing sleep quality and quantity; providing a quiet, dark, and comfortable environment; avoiding caffeine, alcohol, and nicotine before bedtime; encouraging relaxation techniques; and avoiding daytime naps.

• Restoring bowel function and managing constipation by assessing bowel habits, stool characteristics, and abdominal distension; encouraging a high-fiber diet, adequate fluid intake, and regular exercise; administering laxatives or enemas as prescribed; and educating the client on bowel health.

• Preventing aspiration by assessing swallowing ability, oral hygiene, and dentition; providing soft, moist, and easy-to-chew foods; elevating the head of the bed during and after meals; instructing the client to tilt their head forward when swallowing; and monitoring for signs of aspiration such as coughing, choking, or wheezing.

• Preventing fluid imbalance by assessing fluid intake and output, weight changes, skin turgor, mucous membranes, and edema; encouraging adequate fluid intake according to the client’s needs and preferences; administering intravenous fluids as prescribed; and educating the client on signs of dehydration or fluid overload.

A. “I’m sorry that you have to deal with these health problems.

It must be hard for you.” B.

“You have done a great job managing your blood sugar levels and taking your medications.” C.

“You should be more active and socialize more with other people.

It will make you feel better.” D.

“You need to wear your hearing aid at all times.

It will help you communicate better.”