A nurse is implementing interventions to improve the functional status of an older adult client who has diabetes and hypertension.

Which of the following interventions should the nurse include?

(Select all that apply.).

The correct answer isA, B, C and E.These interventions are consistent with the best practices for optimizing functional status in the elderly.

Some explanations for the choices are:.

• Choice A is correct because physical activity and exercise can help maintain muscle strength, joint mobility, balance and coordination, which are essential for functional independence and quality of life.

• Choice B is correct because adequate nutrition and hydration can prevent malnutrition, dehydration and electrolyte imbalance, which can impair physical and cognitive function and increase the risk of complications.

• Choice C is correct because managing chronic diseases and medications can prevent complications, adverse effects and polypharmacy, which can affect functional status and increase the need for health care services.

• Choice D is wrong because providing assistive devices and adaptive equipment is not an intervention to improve functional status, but rather to enhance mobility, safety and independence for patients who already have functional limitations.

The question asks for interventions to improve functional status, not to compensate for it.

• Choice E is correct because modifying the environment can reduce hazards, improve accessibility and facilitate self-care, which can promote functional independence and prevent injuries or falls.

The normal ranges for blood glucose and blood pressure for older adults with diabetes and hypertension are:.

• Blood glucose: 80-130 mg/dL before meals and less than 180 mg/dL after meals.

• Blood pressure: less than 140/90 mmHg or individualized based on comorbidities and risk factors.

The correct answer is C.

Ego integrity vs despair.

According to Erikson’s psychosocial theory, older adults face the challenge of looking back on their lives and evaluating their accomplishments and failures.

If they feel satisfied with their life course, they achieve a sense of ego integrity, which is a feeling of wholeness and coherence.

If they feel regretful or dissatisfied, they experience despair, which is a sense of hopelessness and bitterness.

Choice A is wrong because trust vs mistrust is the first stage of Erikson’s theory, which occurs in infancy.

It involves developing a basic sense of trust in oneself and others based on the quality of caregiving.

Choice B is wrong because generativity vs stagnation is the seventh stage of Erikson’s theory, which occurs in middle adulthood.

It involves contributing to society and the next generation through work, parenting, or other activities.

Choice D is wrong because identity vs role confusion is the fifth stage of Erikson’s theory, which occurs in adolescence.

It involves developing a stable and coherent sense of self and one’s role in society.

Normal ranges for Erikson’s stages are:.

• Trust vs mistrust: birth to 18 months.

• Autonomy vs shame and doubt: 18 months to 3 years.

• Initiative vs guilt: 3 to 6 years.

• Industry vs inferiority: 6 to 12 years.

• Identity vs role confusion: 12 to 18 years.

• Intimacy vs isolation: 18 to 40 years.

• Generativity vs stagnation: 40 to 65 years.

• Ego integrity vs despair: 65 years and older.