A client diagnosed with a stroke is experiencing homonymous hemianopia. The most appropriate nursing intervention to help the client learn to compensate for this deficit during rehabilitation period would be to:

use a cold compress on both eyes.

teach the client scanning techniques.

apply an eye patch to the affected eye.

use eye drops in both eyes daily

Answer and Explanation

The Correct Answer is B

A.   Using a cold compress is typically employed for reducing swelling or discomfort, but it does not address the visual deficits associated with homonymous hemianopia. This intervention would not assist the client in compensating for their visual field loss.
B.   Teaching scanning techniques involves training the client to actively search for visual information from their affected side. This can include turning their head and using their eyes to scan to the left (for right homonymous hemianopia) or to the right (for left homonymous hemianopia). This compensatory strategy is crucial for helping the client navigate their environment safely and effectively during rehabilitation.
C.   Applying an eye patch is not appropriate for homonymous hemianopia, as it may further limit visual input. In fact, patching could exacerbate difficulties by reducing overall vision and is generally more relevant for conditions like amblyopia or for treating diplopia (double vision), rather than compensating for a visual field deficit.
D.   Using eye drops is typically for treating dry eyes, redness, or other ocular conditions, and does not directly address the issues related to homonymous hemianopia. This intervention would not help the client learn to compensate for their visual field loss.

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Correct Answer is B

Explanation

A. After a radical cystectomy, the client may have a urinary diversion (such as a stoma) and should be vigilant about monitoring urine output. Absence of urine output can indicate a serious issue, and notifying the provider is crucial.
B. This statement indicates a need for further clarification. After a radical cystectomy, clients typically do not resume normal voiding because the bladder is removed. Instead, they may have a urinary diversion or need to learn how to manage their new urinary output. Normal voiding as before surgery is not possible, so this statement reflects a misunderstanding of the procedure's implications.
C. After surgery, particularly abdominal surgery like a radical cystectomy, patients are often advised to take stool softeners to prevent constipation. Straining can increase the risk of complications and affect the surgical site, so this is a valid precaution.
D. Monitoring the surgical site for signs of infection, such as redness, swelling, or discharge, is an essential part of post-operative care. Clients should be educated on how to check their surgical site for any concerning changes.

A. be careful with the straight razor." B. insist the nurse use multiple razor blades." C. bring in an electric razor for nurse to use for shaving." D. bring in disposable razors blades to use for, shaving."

Correct Answer is C

Explanation

A. This response shows some awareness but does not indicate a sufficient understanding of the risks. Straight razors can pose a significant risk of cuts and bleeding, especially in a patient who has received t- PA, which can increase the likelihood of bleeding.
B. This response suggests a misunderstanding. Using multiple razor blades does not inherently reduce the risk of bleeding and could increase the chance of cuts or nicks. This response does not indicate an appropriate understanding of safety precautions related to t-PA.
C. This response indicates an understanding of safety precautions. Electric razors are safer for clients who are at risk of bleeding because they do not have sharp blades that can easily cause cuts. This choice minimizes the risk of injury while allowing for personal grooming.
D. While disposable razors may seem convenient, they still carry a risk of cuts and bleeding. This response does not reflect a full understanding of the precautions necessary for a client who has received t-PA, as it does not prioritize safety in the same way that using an electric razor does.

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A client diagnosed with a stroke is experiencing homonymous hemianopia. The most appropriate nursing intervention to help the client learn to compensate for this deficit during rehabilitation period would be to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which statement, made by a client being discharged to home after a radical cystectomy, indicates a need for further clarification by the nurse? "I will:

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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