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. Constipation.

Explanation: Constipation is a common side effect of opioid medications like morphine. Older adults, particularly those on bed rest or with reduced mobility, are already at an increased risk of constipation. Morphine further contributes to this risk by slowing down bowel motility. Preventive measures such as promoting adequate hydration, encouraging fiber intake, and considering stool softeners can help prevent constipation in this scenario.

B. Poor solid food intake.

Explanation: While monitoring and addressing poor solid food intake are important for overall nutritional status, it may not be the immediate priority related to morphine use and postoperative care.

C. Poor liquid intake.

Explanation: Ensuring adequate fluid intake is important for overall hydration, but constipation is a more specific and immediate concern associated with opioid use.

D. Diarrhea.

Explanation: Diarrhea is not a common side effect of morphine and is less likely to be the priority for preventive care in this situation. Constipation is a more anticipated concern when opioids are prescribed.

A. "Use of drugs results in minimal improvement in appetite and weight gain and can have some serious side effects."

Explanation: It is important for the nurse to provide accurate and balanced information about the use of drugs to stimulate appetite. While there are medications available that may be prescribed to improve appetite in certain situations, it is crucial to convey that the effectiveness of such drugs is limited, and they can also have potential serious side effects. Additionally, the decision to use appetite-stimulating drugs should be carefully considered, taking into account the individual's overall health, medical conditions, and potential risks associated with the medications.

B. "There are no drugs that impact appetite or weight gain."

Explanation: This statement is not accurate, as there are medications that may impact appetite and weight gain. However, the effectiveness and appropriateness of such medications should be assessed on a case-by-case basis.

C. "These drugs are not permitted to be used in a long term care facility."

Explanation: This statement is not accurate. The use of appetite-stimulating drugs may be permitted in long-term care facilities, but their use is typically based on individual assessment and consideration of potential risks and benefits.

D. "Yes, there are some very effective drugs out there. Your mother should be on one of them."

Explanation: This statement oversimplifies the decision-making process and may not provide adequate information about the potential risks and benefits of appetite-stimulating drugs. The decision to use such drugs should be made in consultation with the healthcare team, considering the individual's specific circumstances.