A nurse is developing a plan of care for a client who has COPD.
The nurse should include which of the following interventions in the plan?

Choice A rationale

Informing a patient with impaired memory about socially appropriate behavior is generally ineffective as their cognitive deficits hinder their ability to process, retain, and apply this information. Their behavioral challenges often stem from neurological changes rather than a lack of understanding of social norms, leading to frustration for both parties.

Choice B rationale

Assisting with all self-care for a patient with dementia can inadvertently foster dependence and diminish their remaining abilities. Encouraging independence in activities of daily living, even with supervision or partial assistance, is crucial to maintain existing cognitive and functional skills and promote a sense of autonomy and dignity.

Choice C rationale

Maintaining familiar routines of sleep, meals, drug administration, and activities provides a sense of predictability and security for individuals with dementia. This consistency minimizes confusion and agitation by reducing the need to process new information and adapting to changes, thereby supporting cognitive function and emotional well-being.

Choice D rationale

While promoting orientation is important, frequent and repetitive questioning about the day, time, and place can be frustrating and agitating for a patient with significant memory impairment from dementia. Instead, providing subtle environmental cues, consistent verbal reminders, and engaging in reality orientation techniques when appropriate is more beneficial.

Choice A rationale

An impacted fracture occurs when one bone fragment is driven into another, often due to significant axial compression forces. This mechanism results in a stable fracture but can be challenging to reduce due to the interdigitation of the bone ends, potentially causing localized pain and limited range of motion.

Choice B rationale

A greenstick fracture is an incomplete fracture typically seen in children, where one side of the bone cortex is broken and the other side is bent. This occurs because children's bones are more flexible and cartilaginous than adult bones, allowing them to bend rather than completely break under stress.

Choice C rationale

A compression fracture results from a compressive force that causes a bone to collapse, commonly observed in the vertebrae. This type of fracture often occurs in osteoporotic bone due to reduced bone mineral density, leading to loss of vertebral body height and potential neurological deficits if spinal cord compression ensues.

Choice D rationale

A compound fracture, also known as an open fracture, involves a break in the bone where the bone fragments pierce through the skin, exposing the bone to the external environment. This significantly increases the risk of infection and requires immediate surgical debridement and antibiotic therapy to prevent osteomyelitis.