The nurse instructed an older client on the importance of maintaining adequate hydration. Which statement by the client most indicates that additional teaching is needed?
1. "I'll drink water, tea, soda, or juice whenever I feel thirsty."
2. "I can add an extra cup of coffee with breakfast and dinner."
3. "I will set up a schedule to drink water every few hours throughout the day."
4. "If I drink a lot of fluids, I'll get more exercise running to the bathroom."
1. "I'll drink water, tea, soda, or juice whenever I feel thirsty."
Explanation: 1. The client needs additional instructions regarding adequate fluid intake. Because the thirst mechanism becomes blunted with age, the client cannot rely on feeling thirsty as a signal to meet hydration requirements. Also, sweet and caffeinated beverages should be limited.
2. Preferably, the client would add decaffeinated fluids, which are allowed and will not lead to diuresis. However, extra fluid is still a positive step.
3. Use of a schedule to maintain adequate fluid intake is preferred because it provides the client with a continuous stimulus to take fluids. The nurse would like to help the client come up with a more detailed plan, such as drinking an 8 oz glass every two hours.
4. The client can expect to urinate more often with the increased fluid intake. The client should be cautioned to reduce fluid intake closer to bedtime to reduce fall hazards with frequent bathroom trips.
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