An older aphasic client has severe osteoarthritis, bilateral contractures of the lower extremities, and a stage IV pressure ulcer. The nurse practitioner prescribes analgesic medications to be administered around-the-clock, with as-needed doses to be administered as appropriate. What observation by the nurse would indicate that the pain regimen is effective? (Select all that apply.)

Choice A: "Client slept throughout the night" - Good sleep can be an indicator of effective pain management. Pain can disrupt sleep, so if the client is sleeping well, it may suggest that their pain is being effectively managed¹.

Choice B: "Client cooperative during AM care" - If the client is cooperative during care, it may suggest that they are not in significant pain. Uncontrolled pain can make people irritable and uncooperative¹.

Choice C: "Client ate 80% of breakfast, 70% of lunch and 100% of dinner" - Pain can affect appetite. If the client is eating well, it may suggest that their pain is under control¹.

Choice D: "Client winces only when turned and repositioned" - If the client only shows signs of discomfort during movement, it may suggest that their pain is generally well-controlled¹.

Choice E: "Client slept during dressing change" - This is not necessarily an indicator of effective pain management. The client could be sleeping due to fatigue, medication effects, or other reasons unrelated to their pain level¹.

Choice A reason: Skin becomes more vulnerable to sun damage is true because as the skin ages, it loses its elasticity and ability to repair itself from the harmful effects of ultraviolet (UV) radiation. Sun damage can cause wrinkles, age spots, and skin cancer. The nurse would advise the older adult person to protect their skin from the sun by wearing sunscreen, hats, and clothing that covers the skin.

Choice B reason: Sweat gland activity increases is false because as the skin ages, it produces less sweat and oil, which can make the skin dry and prone to itching. The nurse would advise the older adult person to moisturize their skin regularly and avoid hot showers or baths that can dry out the skin.

Choice C reason: Skin becomes darker in unexposed areas is false because as the skin ages, it produces less melanin, the pigment that gives the skin its color. This can make the skin lighter and more sensitive to sunburn. The nurse would advise the older adult person to check their skin for any changes in color, shape, or size of moles or spots that could indicate skin cancer.

Choice D reason: Generous amounts of soap should be used for cleansing is false because as the skin ages, it becomes thinner and more fragile, and can be irritated by harsh chemicals or fragrances. The nurse would advise the older adult person to use mild, unscented soap and water for cleansing, and to pat the skin dry gently.