During an assessment, an older adult male client reports that he fell the night before. What should you follow up with? (Select all that apply.)

Choice A reason: Heart failure can cause fluid retention, which can lead to dehydration if the fluid is not properly balanced.

Choice B reason: Functional impairments can limit the ability to drink or access fluids, which can increase the risk of dehydration.

Choice C reason: Longitudinal furrows on the tongue are a sign of dehydration, as the tongue loses moisture and becomes dry and cracked.

Choice D reason: Hypertension is not directly related to dehydration, although it can be affected by fluid intake and electrolyte balance.

Choice E reason: Diabetes can cause increased urination, which can lead to dehydration if the fluid loss is not replaced.

Choice A reason: Performing all activities of daily living (ADLs) and then resting is not a good instruction for the older adult who has COPD, as it can cause fatigue, shortness of breath, and anxiety. The nurse would advise the older adult to pace themselves and prioritize the most important activities, and to take breaks between tasks.

Choice B reason: Bathing and eating slowly with periodic rest is a good instruction for the older adult who has COPD, as it can help conserve energy, prevent dyspnea, and improve digestion. The nurse would advise the older adult to use a shower chair or a handheld showerhead, to avoid hot water or steam, and to use a fan or an open window for ventilation. The nurse would also advise the older adult to eat small, frequent meals, to avoid foods that cause gas or bloating, and to drink fluids between meals rather than with them.

Choice C reason: Walking short distances without oxygen is not a safe instruction for the older adult who has COPD, as it can cause hypoxia, which is a low level of oxygen in the blood. The nurse would advise the older adult to use oxygen therapy as prescribed by their doctor, and to monitor their oxygen saturation with a pulse oximeter. The nurse would also advise the older adult to exercise regularly, but to start slowly and gradually increase the intensity and duration, and to stop if they feel dizzy, chest pain, or severe breathlessness.

Choice D reason: Bathing right after eating and then resting is not a helpful instruction for the older adult who has COPD, as it can cause indigestion, reflux, or aspiration. The nurse would advise the older adult to wait at least an hour after eating before bathing, and to avoid lying down right after eating or bathing. The nurse would also advise the older adult to elevate their head with pillows when resting or sleeping, and to avoid napping during the day.