The nurse assists an older adult man who is diagnosed with type 2 diabetes mellitus to improve his glucose control. Which of the following instructions does the nurse give to this individual when he plans to walk more than usual in one day?

Choice A reason: Low back pain is a common condition that affects many older adults, as it can be caused by degenerative changes in the spine, disc herniation, spinal stenosis, osteoporosis, or muscle strain. Low back pain can be chronic, meaning it lasts for more than three months, and can interfere with daily activities and quality of life.

Choice B reason: Hypoproteinemia is a condition where the level of protein in the blood is abnormally low, which can be caused by malnutrition, liver disease, kidney disease, or inflammation. Hypoproteinemia can cause symptoms such as edema, fatigue, weakness, or hair loss, but it does not usually cause chronic pain.

Choice C reason: Headaches are a common symptom that can affect people of any age, but they are not necessarily chronic or related to aging. Headaches can be caused by various factors, such as stress, dehydration, sinus infection, migraine, or medication. Headaches can be acute, meaning they last for a short time, or chronic, meaning they occur for more than 15 days a month.

Choice D reason: Osteoarthritis is a degenerative joint disease that affects many older adults, as it causes the cartilage that cushions the joints to wear away, resulting in pain, stiffness, swelling, and reduced mobility. Osteoarthritis can affect any joint, but it is more common in the knees, hips, hands, and spine. Osteoarthritis can be chronic, meaning it worsens over time, and can limit the ability to perform daily tasks and enjoy life.

Choice E reason: Hip replacement is a surgical procedure that replaces a damaged or diseased hip joint with an artificial one, which can improve pain, function, and quality of life. However, hip replacement can also cause chronic pain, either due to complications, such as infection, dislocation, or loosening of the implant, or due to persistent inflammation, nerve damage, or scar tissue.

Choice A reason: Encouraging the client to use a cane when ambulating is not a cause of concern for the home health nurse, as it is a way of providing support and stability for the client, and preventing falls or injuries.

Choice B reason: Keeping several low wattage night lights on in the evening is not a cause of concern for the home health nurse, as it is a way of improving the visibility and orientation for the client, and reducing the risk of tripping or stumbling in the dark.

Choice C reason: Keeping the side rails up on the client’s bed at night is a cause of concern for the home health nurse, as it is a way of restricting the client’s mobility and increasing the likelihood of entrapment, injury, or death. Side rails can also create a false sense of security and encourage the client to climb over them, which can result in falls or fractures.

Choice D reason: Installing wooden railings on the stairway to the bathroom is not a cause of concern for the home health nurse, as it is a way of enhancing the safety and accessibility for the client, and preventing falls or slips on the stairs.