The nurse teaches an older adult diagnosed with diabetes mellitus and prescribed metoprolol to recognize early clinical indicators of hypoglycemia. Which clinical indicators of hypoglycemia does the nurse include in client teaching as the indicators this man is most likely to detect? (Select all that apply.)

Choice A reason: Older adult’s self-report is not the most helpful tool, as it may not be reliable or consistent in older adults, especially if they have cognitive impairment, communication difficulties, or cultural barriers. Older adults may also underreport or overreport their pain due to fear, stoicism, or expectations.

Choice B reason: FPS-R (Faces Pain Scale-Revised) is not the most helpful tool, as it may not be suitable or valid for older adults, especially if they have visual impairment, facial paralysis, or dementia. FPS-R is a pictorial scale that uses six facial expressions to represent different levels of pain intensity, from 0 (no pain) to 10 (very much pain).

Choice C reason: Pain medication frequency is not the most helpful tool, as it may not reflect the actual pain level or the effectiveness of the pharmacotherapy. Pain medication frequency may vary depending on the type, dose, route, and duration of the medication, as well as the individual response and tolerance of the older adult.

Choice D reason: Older adult's pain diary is the most helpful tool, as it can provide a comprehensive and longitudinal record of the pain experience, including the location, intensity, quality, frequency, duration, triggers, relievers, and impact of the pain. A pain diary can also help track the use and response of the comfort measures, activity, and pharmacotherapy, and identify the patterns and trends of the pain.

Choice E reason: None of the above is not the correct answer, as there is one choice that is the most helpful tool for the nurse to use.

Choice A reason: Overflow incontinence is a type of urinary incontinence that occurs when the bladder becomes overfilled and cannot empty completely. This causes urine to leak out of the bladder, even when the person does not feel the urge to urinate. A large residual urine volume is a common sign of overflow incontinence, as it indicates that the bladder is not emptying properly.

Choice B reason: Urge incontinence is a type of urinary incontinence that occurs when the bladder contracts involuntarily and causes a sudden and strong urge to urinate. This can result in urine leakage before the person can reach the toilet. A large residual urine volume is not a typical feature of urge incontinence, as the bladder tends to empty frequently and urgently.

Choice C reason: Stress incontinence is a type of urinary incontinence that occurs when the pelvic floor muscles that support the bladder are weakened or damaged. This causes urine to leak out of the bladder when the person coughs, sneezes, laughs, or exerts pressure on the abdomen. A large residual urine volume is not a common symptom of stress incontinence, as the bladder does not overfill or contract involuntarily.

Choice D reason: Functional incontinence is a type of urinary incontinence that occurs when the person has normal bladder function but cannot reach the toilet in time due to physical or mental impairments. This can be caused by mobility problems, cognitive decline, dementia, or environmental barriers. A large residual urine volume is not a characteristic of functional incontinence, as the bladder can empty normally when the person has access to the toilet.