Falls are the leading cause of injury death in adults aged 65 and older.
Before you read
Test yourself first: 5 questions
Question 1 of 5
An older adult female is admitted with a urinary tract infection (UTI). Which atypical presentation should the nurse recognize as a possible sign of UTI in this population?
Answer: A. Older adults often do not show classic UTI symptoms (dysuria, frequency, urgency). Instead, new-onset confusion, acute change in mental status, or behavioral changes are common and important indicators of UTI in the elderly. Bradycardia and hyperglycemia are not characteristic UTI presentations.
Question 2 of 5
A nurse suspects that an older adult client is being physically abused by a caregiver. What is the nurse's legal obligation in most jurisdictions?
Answer: B. Nurses are mandatory reporters of suspected abuse or neglect of vulnerable persons, including older adults and children. Reasonable suspicion, not proof, triggers the duty to report to the appropriate authorities such as adult protective services. The nurse documents objective findings and reports per facility policy and law.
Question 3 of 5
A nurse calculates a child's dose and finds it exceeds the maximum recommended adult dose listed in the drug reference. What is the most appropriate action?
Answer: B. A pediatric calculated dose should never exceed the safe adult maximum. When it does, the nurse must hold the dose and verify the order with the prescriber and pharmacy before administering, because an error is likely.
Question 4 of 5
Which site is preferred for an intramuscular injection in an adult because it is away from major nerves and blood vessels?
Answer: A. The ventrogluteal site is preferred for adult IM injections because it is free of major nerves and large vessels and can accommodate a moderate volume. The deltoid is reserved for smaller volumes such as vaccines.
Question 5 of 5
An older adult client is identified as high fall-risk. Which intervention is the priority to reduce fall risk?
Answer: B. Keeping the bed in the lowest position with the call light within reach and wheels locked directly reduces injury and lets the client summon help instead of getting up alone. Side rails up on all four rails is considered a restraint and can increase injury from climbing over. Restricting fluids and sedating the client are inappropriate and unsafe.
Keep the streak going with more questions like these, each with a full rationale.
What is older adult safety?
Age-related changes (decreased vision, slower reflexes, polypharmacy, orthostatic hypotension) increase risk. Safety interventions follow Maslow's physiologic and safety needs.
Key points to remember
- Falls are the leading cause of injury death in adults aged 65 and older.
- Polypharmacy, sedatives, antihypertensives, and diuretics increase fall risk.
- Orthostatic hypotension causes dizziness; rising slowly reduces falls.
- Sensory decline (vision, hearing, proprioception) raises injury and medication-error risk.
- Thin skin and reduced subcutaneous tissue increase risk of pressure injury and skin tears.
- Decreased temperature regulation raises risk of hypothermia and hyperthermia.
Nursing priorities
- Perform a fall-risk assessment and keep the bed low, locked, and call light within reach.
- Ensure adequate lighting, nonslip footwear, clutter-free paths, grab bars, and assistive devices.
- Review medications for those increasing fall risk and report sedating or duplicate drugs.
- Teach the patient to rise slowly in stages to prevent orthostatic dizziness.
- Use the least restrictive measures and reassess hourly rather than relying on restraints.
Labs & values
Patient teaching
- Remove throw rugs, add night lights and grab bars, and keep frequently used items within reach.
- Stand up slowly from lying or sitting and use a cane or walker as prescribed.
Red flags: report now
- A fall with head injury or anticoagulant use requires immediate neuro assessment and provider notification.
- Never use restraints as a first-line fall measure; they increase injury, agitation, and require an order.
- New confusion in an older adult may signal infection, hypoxia, or a stroke and is reported now.
References
Clinical references for this topic
