Which of the following are reasons to conduct a health history using an interpreter? (Select all that apply)

Choice A reason: Stage 4 pressure injury involves full-thickness tissue loss with exposed muscle, bone, or tendon, as described with a deep depression and visible bone. This severe stage requires aggressive interventions like debridement or surgery. Accurate staging ensures proper wound care, preventing infection and promoting healing in advanced pressure injuries.

Choice B reason: Stage 3 involves full-thickness loss to subcutaneous tissue, not muscle or bone, unlike the described injury with visible bone (stage 4). Misstaging as 3 underestimates severity, risking inadequate treatments like simple dressings, delaying surgical intervention or infection control critical for deep pressure injuries with bone exposure.

Choice C reason: Stage 1 is intact skin with erythema, not a deep lesion with bone exposure, which is stage 4. Misstaging as 1 grossly underestimates severity, neglecting urgent needs like debridement or antibiotics, risking infection, sepsis, or further tissue loss in severe pressure injuries requiring advanced wound management.

Choice D reason: Stage 2 involves partial-thickness loss with a shallow wound, not deep muscle or bone exposure, as in stage 4. Misstaging as 2 risks inadequate care, like topical treatments instead of surgical intervention, delaying healing and increasing complications like osteomyelitis in severe pressure injuries with visible bone.

Choice A reason: Urinary retention involves inability to empty the bladder, causing overflow, not involuntary leakage during laughing or sneezing, which indicates stress incontinence. Misdiagnosing retention risks inappropriate treatments like catheterization, delaying pelvic exercises or medications, critical for managing stress incontinence and improving quality of life in affected patients.

Choice B reason: Constipation affects bowel function, not urinary control, unlike stress incontinence, where leakage occurs during physical stress like sneezing. Assuming constipation misguides diagnosis, risking neglect of urinary interventions like Kegel exercises, essential for strengthening pelvic muscles and preventing incontinence-related limitations in daily activities.

Choice C reason: Hiatal hernia causes gastrointestinal symptoms like reflux, not urinary leakage during activities, which defines stress incontinence. Misdiagnosing hernia risks overlooking pelvic floor issues, delaying treatments like biofeedback, critical for managing incontinence, reducing activity limitations, and improving comfort in patients with stress-related urine loss.

Choice D reason: Stress incontinence involves involuntary urine leakage during activities like laughing or sneezing due to weakened pelvic floor muscles, common in women. Recognizing this guides interventions like pelvic exercises or surgery, critical for reducing activity limitations, improving quality of life, and addressing physical and emotional impacts in affected patients.