A nurse is caring for a client who had a right-sided stroke and is exhibiting homonymous hemianopsia when eating. Which of the following actions should the nurse take?
Provide a nonskid mat to reduce plate movement.
Encourage the use of wide grip utensils.
Remind that the client look for food on the left side of the tray.
Encourage the client to use her right hand when feeding herself.
The Correct Answer is C
A. A nonskid mat might be helpful for plate stability, but it does not address the visual deficit related to homonymous hemianopsia.
B. Wide grip utensils are useful for motor difficulties, but the primary issue here is a visual field deficit, not motor impairment.
C. Homonymous hemianopsia results in loss of vision in the same half of the visual field in both eyes. Encouraging the client to turn her head or look for food on the affected side (left side of the tray) can help compensate for the visual loss.
D. While using the right hand may be important after a right-sided stroke, the more pressing issue here is addressing the visual field deficit, not hand preference.
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Correct Answer is A
Explanation
A. Autonomic dysreflexia is often triggered by a noxious stimulus, such as bladder distention. Preventing bladder distention by ensuring regular bladder emptying can help prevent the condition.
B. Elevating the client's head is a response to autonomic dysreflexia but does not prevent it from occurring.
C. Providing analgesia for headaches addresses a symptom of autonomic dysreflexia but does not prevent it.
D. Monitoring for elevated blood pressure is important in detecting autonomic dysreflexia once it has started, but it does not prevent it.
Correct Answer is D
Explanation
A. Wearing gloves when removing food from the freezer is appropriate and helps prevent exposure to cold, which can trigger symptoms of Raynaud's phenomenon.
B. Completing a smoking cessation program is beneficial, as smoking can exacerbate symptoms of Raynaud's.
C. Avoiding stressful situations is advisable since stress can trigger vasoconstriction and exacerbate symptoms
.
D. Keeping the house at a cool temperature is not recommended, as cold environments can provoke Raynaud's symptoms; the client should aim to maintain a warm environment to minimize triggers.