An older adult diagnosed with Type II DM who is being treated with insulin wants to increase his activity level and begin a walking program. What recommendations should the nurse provide to this client?

Choice A: Increase in physical activity

Physical activity can strengthen the muscles that help control urination. Exercises such as Kegels can specifically target these muscles, leading to improvements in urinary incontinence.

Choice B: Blood sugar control

While blood sugar control is important for overall health and can prevent complications from diabetes, it is not directly associated with improvements in urinary incontinence.

Choice C: Smoking cessation

Smoking can lead to coughing which puts pressure on the bladder and can exacerbate symptoms of urinary incontinence. Therefore, smoking cessation can lead to improvements.

Choice D: Weight reduction

Excess weight can put pressure on the bladder and surrounding muscles. Losing weight can reduce this pressure and improve symptoms of urinary incontinence.

There is no Choice E in this case. Each of these interventions can contribute to overall health and may indirectly affect urinary incontinence, but Choices A, C, and D are the most directly related to improvements in this condition.

Choice A reason: Raises all four side rails is not the best intervention, as it may not prevent the client from falling and may increase the risk of injury and entrapment. Raising all four side rails may also be considered a form of restraint, which should be avoided unless absolutely necessary.

Choice B reason: Orders a two-person assist with a transfer is not the best intervention, as it may not be appropriate for the client's level of mobility and may reduce the client's independence and self-esteem. The nurse should assess the client's ability to transfer and use the appropriate assistive device and number of staff to ensure safety and comfort.

Choice C reason: Gives the client a dry erase board is the best intervention, as it can facilitate the client's communication and expression of needs and preferences. The client may have difficulty speaking or writing due to the stroke, which can affect the language and motor areas of the brain. A dry erase board can allow the client to use simple words, symbols, or drawings to convey their messages.

Choice D reason: May need to incorporate repetition is not the best intervention, as it is not specific and may not be effective for the client's learning and retention. The nurse should use individualized and evidence-based strategies to teach the client and their family about the stroke, its effects, and the rehabilitation plan. Repetition may be one of the strategies, but not the only one.

Choice E reason: None of the above is not the correct answer, as there is one choice that is the best intervention for the nurse to implement when caring for this client.