An older client has recently been put on high risk for fall precautions after a medication for high blood pressure was started. The client's daughter questions why this precaution was put in place. How should the nurse respond to the daughter?
1. "Every older client is automatically put on fall risk precautions."
2. "The client is attached to IV tubing and sequential compression devices."
3. "The client is on multiple medications that may have an interaction."
4. "The client was recently started on a medication that could cause a fall."
4. "The client was recently started on a medication that could cause a fall."
Explanation: 1. Being older increases the chance of needing fall precautions, but every older client is not automatically put on high fall risk.
2. Being attached to multiple medical devices does not automatically indicate a need for fall precautions.
3. Polypharmacy can increase fall risk, but this is determined for each client after examining their personal medication profile.
4. Medications have been associated with the occurrence of falls and related injuries. Antihypertensives can cause hypotension, which can result in falls. This would indicate a need to place the client on high fall risk.
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