You notice that your older adult male client frequently knocks his arm or hand against door frames or chair backs and then develops a purpura. What do you advise your client to do? (Select all that apply.)

Choice A reason: Asking about the circumstances behind the fall(s) can help you identify the possible risk factors and causes of the fall(s), such as environmental hazards, medications, chronic conditions, or acute illnesses. Asking about the circumstances can also help you determine the severity and urgency of the situation, and whether the client needs further evaluation or referral.

Choice B reason: Assessing for any injuries the client might have is important, but it is not the first thing you should do after a client reports a fall. You should first ask about the circumstances to rule out any life-threatening or serious injuries that may require immediate attention. Assessing for injuries is part of the comprehensive fall risk assessment that should be done after the initial screening.

Choice C reason: Evaluating the client for gait and balance is also important, but it is not the first thing you should do after a client reports a fall. You should first ask about the circumstances to rule out any underlying medical conditions that may affect the client's gait and balance. Evaluating gait and balance is part of the comprehensive fall risk assessment that should be done after the initial screening.

Choice D reason: Asking about the history or frequency of falls can help you assess the client's fall risk and identify any patterns or trends in the client's fall history. Asking about the history or frequency of falls can also help you tailor the appropriate interventions and prevention strategies for the client.

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.