An older adult client in a long-term care facility has dementia and begins to have frequent episodes of urinary incontinence. After the provider finds no medical cause for his incontinence, which of the following interventions should the nurse initiate to manage this behavior?

Remind the client to tell the nurse when he has to urinate

Use adult diapers to prevent frequent clothing changes.

Take the client to the bathroom on an every-2-hr schedule.

Request a prescription for an indwelling urinary catheter.

Answer and Explanation

The Correct Answer is C

A. Remind the client to tell the nurse when he has to urinate.
Reminding the client may not be effective, as individuals with dementia may have difficulty expressing their needs or may forget to communicate when they need to use the bathroom. It relies on the client's ability to remember and communicate.

B. Use adult diapers to prevent frequent clothing changes.
While adult diapers can be part of a comprehensive plan for managing incontinence, they should not be the sole intervention. Relying solely on diapers does not address the underlying causes of incontinence and may not promote optimal dignity and quality of life.

C. Take the client to the bathroom on an every-2-hr schedule.
This is the correct choice. Taking the client to the bathroom on a regular schedule (timed voiding) is a proactive approach to managing urinary incontinence in individuals with dementia. It helps reduce the likelihood of accidents by ensuring regular opportunities for toileting.

D. Request a prescription for an indwelling urinary catheter.
Indwelling urinary catheters are generally not recommended for managing routine urinary incontinence due to the associated risks, including infection. Catheters should be used judiciously and based on medical necessity.

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Correct Answer is C

Explanation

A. “You should avoid the use of cell phones after the pacemaker is placed.”

This statement is not accurate. In general, the use of cell phones is considered safe for individuals with pacemakers. However, it is recommended to keep the phone on the opposite side of the pacemaker to minimize any potential interference.

B. “Swelling and redness of the operative site are normal findings for the first two days following the

procedure.”

This statement is partially accurate. Swelling and redness at the operative site can be expected immediately after the procedure. However, if these signs persist or worsen after the first two days, it may indicate a potential issue, and the healthcare provider should be notified.

C. “You will need to limit movement of the arm on the side of the pacemaker.”

This statement is accurate. Limiting movement of the arm on the side of the pacemaker is a standard precaution to prevent dislodgement of the leads and allow proper embedding of the pacemaker leads into the surrounding tissues.

D. “Hiccups following pacemaker placement are an expected response.”

This statement is not accurate. Hiccups are not typically associated with pacemaker placement. If the client experiences unexpected symptoms, such as hiccups, it is important to report them to the healthcare provider for further evaluation.

A. Discuss a referral to home health and hospice care with the client and family. B. Contact the social worker to assist with nursing home placement. C. Talk with the provider about extending the client’s hospital stay. D. Instruct the family about meeting the client’s palliative care needs at home.

Correct Answer is A

Explanation

A. Discuss a referral to home health and hospice care with the client and family.

This is the correct answer. Discussing a referral to home health and hospice care addresses the client's expressed desire to go home and provides the necessary support and care for both the client and the family during this challenging time.

B. Contact the social worker to assist with nursing home placement.

This option may not align with the client's wish to go home. Nursing home placement may not be the preferred choice, especially when the client wants to spend their final days in a home setting.

C. Talk with the provider about extending the client’s hospital stay.

Prolonging the hospital stay may not meet the client's expressed wish to go home and may not provide the same level of comfort and support as home health and hospice care.

D. Instruct the family about meeting the client’s palliative care needs at home.

While providing information about meeting palliative care needs at home is important, it is more comprehensive to involve home health and hospice services, which can provide skilled care, emotional support, and assistance to the family in managing the client's care needs at home.

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An older adult client in a long-term care facility has dementia and begins to have frequent episodes of urinary incontinence. After the provider finds no medical cause for his incontinence, which of the following interventions should the nurse initiate to manage this behavior?

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