As a nurse caring for a cognitively impaired older adult client, you need to observe for which of the following? (Select all that apply.)

A. Defecation less than once each day is not necessarily constipation.

Explanation: The frequency of bowel movements varies among individuals, and defecating less than once each day does not necessarily indicate constipation. Normal bowel habits can differ, and what is considered regular for one person may not be the same for another. Constipation is better assessed by considering other factors such as stool consistency, straining during bowel movements, and feelings of incomplete evacuation.

B. Leaking liquid feces should be treated as diarrhea.

Explanation: Leaking liquid feces may be indicative of diarrhea, but it is not the only factor to consider. The cause of diarrhea should be investigated, and treatment will depend on the underlying reason, which may include infections, medications, or other medical conditions.

C. Mineral oil is recommended as a laxative for the older adult.

Explanation: Mineral oil is generally not recommended as a laxative for older adults. It can interfere with the absorption of fat-soluble vitamins and may have adverse effects. There are other safer and more effective laxative options that healthcare providers may recommend.

D. Excessive sleep can be a symptom of constipation.

Explanation: Excessive sleep is not typically considered a symptom of constipation. Constipation is more commonly associated with symptoms such as infrequent bowel movements, difficulty passing stool, and abdominal discomfort. Sleep disturbances may have various causes, but they are not a direct symptom of constipation.

A. Semiprivate room.

Explanation: Medicare can cover the cost of a semiprivate room during a qualifying hospital stay or skilled nursing facility stay.

B. Hospice care.

Explanation: Medicare provides coverage for hospice care for individuals with a terminal illness and a life expectancy of six months or less.

C. Custodial care.

Explanation: Custodial care, which involves assistance with activities of daily living (ADLs) such as bathing, dressing, and feeding, is generally not covered by Medicare. Medicare primarily covers medically necessary and skilled care, such as hospital stays, certain nursing home stays, hospice care, and some home health care services. Custodial care, which focuses on assistance with routine personal care, is considered non-medical and is typically not covered by Medicare.

D. Skilled care.

Explanation: Medicare covers skilled care, including services provided by healthcare professionals such as nurses and therapists, when deemed medically necessary. Skilled care is typically required to improve or maintain a person's condition.