A female patient who had a stroke 24 hours ago has expressive ...

[APUS57]

A female patient who had a stroke 24 hours ago has expressive aphasia. The nurse identifies the nursing diagnosis of impaired verbal communication. An appropriate nursing intervention to help the patient communicate is to
 
  a. ask questions that the patient can answer with yes or no.
  b. develop a list of words that the patient can read and practice reciting.
  c. have the patient practice her facial and tongue exercises with a mirror.
  d. prevent embarrassing the patient by answering for her if she does not respond.

Question 2

For a patient who had a right hemisphere stroke the nurse establishes a nursing diagnosis of
 
  a. risk for injury related to denial of deficits and impulsiveness.
  b. impaired physical mobility related to right-sided hemiplegia.
  c. impaired verbal communication related to speech-language deficits.
  d. ineffective coping related to depression and distress about disability.

[Sammyo]

Answer to Question 1

ANS: A
Communication will be facilitated and less frustrating to the patient when questions that require a yes or no response are used. When the language areas of the brain are injured, the patient might not be able to read or recite words, which will frustrate the patient without improving communication. Expressive aphasia is caused by damage to the language areas of the brain, not by the areas that control the motor aspects of speech. The nurse should allow time for the patient to respond.

Answer to Question 2

ANS: A
The patient with right-sided brain damage typically denies any deficits and has poor impulse control, leading to risk for injury when the patient attempts activities such as transferring from a bed to a chair. Right-sided brain damage causes left hemiplegia. Left-sided brain damage typically causes language deficits. Left-sided brain damage is associated with depression and distress about the disability.