Following a brain attack, the 45-year-old female client was very ...

[CharlieWard]

Following a brain attack, the 45-year-old female client was very confused She was having diffi-culty responding appropriately to the nurse and to her family members.
 
  The client's daughter was concerned that her mother was suffering from a mental breakdown, even though she had no history of mental illness. The best information that the nurse can share with the client's daughter is:
  1. Your mother appears to have aphasia as a result of her stroke.
  2. Your mother will be just fine in no time.
  3. Your mother has been through a lot as a result of her stroke.
  4. We can have a psychiatric workup done if you would like.

Question 2

A 47-year-old male client has come in to his primary health care provider's office for his annual checkup.
 
  The client shares with the nurse that his wife thinks he is suffering from hearing loss. Which of the following responses by the nurse would be most appropriate?
  1. You are approaching an age when it is common to start having some hearing loss.
  2. Do you work in a noisy environment?
  3. You don't seem to have hearing problems to me.
  4. Has anyone else noticed that you are having hearing problems?

[popopong]

Answer to Question 1

ANS: 1
The most common language disorder following a stroke is aphasia. As a result of a disruption in blood flow to the brain, the speech center becomes damaged, altering a person's ability to either use or understand spoken words. Depending on the type of aphasia, the inability to communicate is often frustrating and frightening. Initially you need to establish very basic communication and recognize that aphasia does not indicate intellectual impairment or degeneration of personality. Explain situations and treatments that are pertinent to the client because he or she is able to un-derstand the speaker's words. Because a stroke often causes partial or complete paralysis of one side of the client's body, an aphasic client will need special assistive devices. There are commu-nication boards that have been developed for several levels of disability. Sensitive pressure switches, activated by the touch of an ear, nose, or chin, control electronic communication boards. Clients who have had a stroke usually acquire referrals to speech therapists to develop appropriate rehabilitation plans.

Answer to Question 2

ANS: 2
In the case of sensory alterations you need to integrate knowledge of the pathophysiology of sensory deficits, factors that affect sensory function, and therapeutic communication principles. A person's occupation places him or her at risk for hearing, visual, and peripheral nerve altera-tions. Individuals who have occupations involving exposure to high noise levels (e.g., factory or airport workers) are at risk for noise-induced hearing loss and need to be screened for hearing impairments. Hazardous noise is common in work settings as well as recreational activities. Be careful to not automatically assume that a client's sensory problem is related to advancing age. For example, adult sensorineural hearing loss is often due to exposure to excess and prolonged noise or metabolic, vascular, and other systemic alterations. Collect a history that also assesses the client's current sensory status and the degree to which a sensory deficit affects the client's life-style, psychosocial adjustment, developmental status, self-care ability, health promotion habits, and safety.

[CharlieWard]

Excellent

[Jsherida]

TYSM