A nurse is teaching a client about how to use her new hearing aids. Which of the following statements should the nurse identify as an indication that the client needs further instruction?

A: A client with lactose intolerance does not have an increased risk of aspiration while eating. Lactose intolerance affects the digestive system, causing symptoms like bloating and diarrhea when consuming dairy products, but it does not impact swallowing.

B: A client who has had a cerebrovascular accident (CVA) or stroke is at increased risk of aspiration. Strokes can affect the muscles involved in swallowing, leading to dysphagia (difficulty swallowing) and increasing the risk of food or liquid entering the airway.

C: A client who has had prolonged diarrhea is not typically at increased risk of aspiration. Diarrhea affects the gastrointestinal system but does not directly impact the swallowing mechanism.

D: A client who has had trauma to the head and neck is at increased risk of aspiration. Such trauma can damage the structures involved in swallowing, leading to dysphagia and a higher likelihood of aspiration.

E: A client who is 4 hours postoperative following a leg amputation with general anesthesia is at increased risk of aspiration. General anesthesia can depress the gag reflex and swallowing function, making it easier for food or liquid to enter the airway during the immediate postoperative period.

A: Using a microwave for cooking is generally safe for older adults with decreased vision. Microwaves are user-friendly and reduce the risk of burns or fires compared to stovetops. However, it is important to ensure that the microwave is at an accessible height and that the user can read the controls or has them memorized.

B: Handrails in the bathroom are a safety feature, not a risk. They provide support and stability, reducing the likelihood of falls, which is crucial for individuals with decreased vision. Properly installed handrails can significantly enhance bathroom safety.

C: Electrical cords placed along the walls are typically not a safety risk if they are secured properly and do not create tripping hazards. It is important to ensure that cords are not loose or crossing walkways where they could cause falls.

D: Scatter rugs in the kitchen are a significant safety risk for older adults with decreased vision. These rugs can easily cause tripping and falling, especially if they are not secured with non-slip backing. Removing scatter rugs or securing them properly is essential to prevent accidents.