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: This is incorrect because using smooth muscle relaxants is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Smooth muscle relaxants are medications that can relax the bladder and reduce the urge to urinate, but they can also cause side effects such as dry mouth, constipation, or blurred vision. They are not suitable for all types of urinary incontinence, and they should be used with caution and under medical supervision.

Choice B reason: This is incorrect because availability of protective rubber garments is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Protective rubber garments are devices that can prevent urine leakage and protect the skin and clothing, but they can also cause skin irritation, infection, or odor. They are not a cure for urinary incontinence, and they should be used as a last resort or in combination with other interventions.

Choice C reason: This is incorrect because using indwelling urinary catheters is not the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Indwelling urinary catheters are tubes that can drain urine from the bladder and collect it in a bag, but they can also cause complications such as urinary tract infections, bladder spasms, or trauma. They are not recommended for long-term use, and they should be used only when other methods have failed or are contraindicated.

Choice D reason: This is correct because maintaining an attitude that is respectful and positive about resolving the problem is the most important aspect of care for the nurse to maintain when assisting an older client with urinary incontinence. Urinary incontinence can cause embarrassment, shame, isolation, or depression in older clients, and they may be reluctant to seek help or comply with treatment. The nurse should respect the client's dignity, privacy, and preferences, and provide education, support, and encouragement. The nurse should also assess the underlying causes and contributing factors of urinary incontinence, and implement individualized and evidence-based interventions.

Choice A reason: A detached retina is a serious condition that occurs when the retina, the light-sensitive layer of tissue at the back of the eye, separates from its underlying support tissue. It can cause vision loss or blindness if not treated promptly. However, it does not usually cause intense headaches or bloodshot eyes, but rather flashes of light, floaters, or a curtain-like shadow over the visual field.

Choice B reason: Macular degeneration is a common eye disorder that affects the macula, the central part of the retina that is responsible for sharp and detailed vision. It can cause blurred or distorted vision, especially in the center of the visual field. However, it does not usually cause intense headaches or bloodshot eyes, but rather difficulty reading, recognizing faces, or seeing colors.

Choice C reason: Cataracts are cloudy areas in the lens of the eye that can impair vision. They are usually related to aging, but can also be caused by other factors such as diabetes, trauma, or radiation. They can cause blurred or dim vision, sensitivity to light, or halos around lights. However, they do not usually cause intense headaches or bloodshot eyes, but rather gradual and painless vision loss.

Choice D reason: Angle-closure glaucoma is a type of glaucoma that occurs when the drainage angle of the eye becomes blocked, causing a sudden increase in the pressure inside the eye. It can damage the optic nerve and lead to permanent vision loss if not treated immediately. It can cause intense headaches, bloodshot eyes, blurred vision, nausea, vomiting, or seeing rainbow-colored rings around lights. It is a medical emergency that requires immediate attention.