The gerontological nurse collaborates with the wound care team about an older client who has an ulcer. How is this nurse demonstrating leadership in the care of older people?

Choice A reason: Having stable vital signs does not necessarily mean that the client is not experiencing pain. Vital signs can be affected by various factors, such as medications, stress, or emotions, and may not reflect the true level of pain.

Choice B reason: Holding abdomen tightly is a possible sign of pain, especially if the client had abdominal surgery or has a condition that affects the digestive system. The client may be guarding the painful area or trying to relieve the discomfort.

Choice C reason: Not verbalizing is not a reliable indicator of pain, especially for clients with dementia who may have difficulty communicating or expressing their feelings. The nurse should look for other cues, such as facial expressions, body language, or behavioral changes, to assess the client's pain.

Choice D reason: Moving during sleep is not a specific sign of pain, and may be normal for some clients. However, if the client is restless, agitated, or moaning during sleep, it may indicate that the client is in pain and needs intervention.

Choice A reason: This is incorrect because 120/80 mm Hg is a normal blood pressure, not a high risk factor for diabetes mellitus. High blood pressure, or hypertension, is a common complication of diabetes mellitus, as it can damage the blood vessels and increase the risk of cardiovascular disease. However, having a normal blood pressure does not rule out the possibility of having diabetes mellitus, as other factors, such as blood sugar level, family history, or lifestyle, can also influence the risk.

Choice B reason: This is incorrect because total cholesterol 198 mg/dL is a borderline high cholesterol level, not a high risk factor for diabetes mellitus. High cholesterol, or hyperlipidemia, is a common complication of diabetes mellitus, as it can affect the metabolism of fats and increase the risk of atherosclerosis and cardiovascular disease. However, having a borderline high cholesterol level does not confirm the diagnosis of diabetes mellitus, as other factors, such as blood sugar level, family history, or lifestyle, can also influence the risk.

Choice C reason: This is incorrect because palpable peripheral pulses are a normal finding, not a high risk factor for diabetes mellitus. Peripheral pulses are the pulsations of the arteries that can be felt in the extremities, such as the wrists or ankles. Palpable peripheral pulses indicate that the blood flow to the extremities is adequate and not compromised by diabetes mellitus. However, having palpable peripheral pulses does not rule out the possibility of having diabetes mellitus, as other factors, such as blood sugar level, family history, or lifestyle, can also influence the risk.

Choice D reason: This is correct because 68 years of age is a high risk factor for diabetes mellitus. Age is one of the non-modifiable risk factors for diabetes mellitus, as the risk increases with advancing age. This is because aging can affect the insulin production and sensitivity, as well as the body composition and function. Older adults are more likely to have diabetes mellitus than younger adults, especially if they have other risk factors, such as obesity, family history, or sedentary lifestyle. Therefore, 68 years of age is a high risk factor for diabetes mellitus.