An older adult male client reports nocturia with difficulty starting his urine stream. Which additional assessment should the nurse perform to obtain further data related to this information?

A. Distinguish between symptoms caused by disease and those due to aging: While differentiating age-related changes from disease symptoms is important, it is a general consideration. It does not directly address safety or management concerns specific to this client’s multiple chronic conditions and recent surgical history.

B. Obtain a medication history including prescription and nonprescription drugs: This is the most crucial step, especially in older adults with multiple chronic conditions. Polypharmacy increases the risk of drug interactions, side effects, and complications especially after surgery or when managing conditions like hypertension, arthritis, and constipation.

C. Emphasize the need to place advance directives in the medical record: While advance directives are important for long-term care planning, they are not an immediate priority in a routine follow-up unless there is a known acute or terminal condition that requires urgent decision-making support.

D. Conduct an assessment of functional capacity and environmental hazards: This is relevant for fall prevention and maintaining independence, particularly after eye surgery. However, ensuring accurate medication use and identifying potential interactions or duplications takes precedence in immediate clinical relevance.

A. Ecchymosis: Ecchymosis refers to larger areas of bruising or discoloration due to bleeding under the skin, typically caused by trauma. It appears as purple or bluish patches but does not present as tiny pinpoint spots.

B. Hematoma: A hematoma is a localized collection of blood under the skin or tissue that results in swelling and discoloration. It is typically raised and larger than petechiae, often caused by blunt force trauma.

C. Petechiae: Petechiae are small, pinpoint, round red or purple spots caused by minor bleeding under the skin. They are flat, do not blanch with pressure, and are often associated with pressure or trauma. In the context of intimate partner violence, petechiae can be a sign of strangulation or other abuse-related injuries.

D. Vesicle: A vesicle is a small, fluid-filled blister on the skin, commonly associated with infections like herpes or chickenpox. They appear as a raised lesion containing clear fluid. It is not red or pinpoint in appearance and would not match the described findings in this scenario.