A family member of a patient diagnosed with a hemorrhagic stroke asks if the patient can receive anticoagulant therapy to improve their outcome. The nurse explains that anticoagulant therapy for the patient

Choice A reason: "Try relaxation and warm moist compresses for your headaches and document your response." is not the best instruction by the nurse to gather additional data before the appointment. It is a suggestion for self-care and pain relief, but it does not provide any information about the cause, type, or severity of the headaches.

Choice B reason: "Keep a diary of your headaches, recording symptoms, timing, and headache triggers." is the best instruction by the nurse to gather additional data before the appointment. It is a useful tool for collecting objective and subjective data about the headaches, such as their frequency, duration, intensity, location, quality, associated symptoms, and precipitating factors. This can help the primary care practitioner to diagnose the type of headache, such as migraine, tension, or cluster, and prescribe the appropriate treatment.

Choice C reason: "Call and come in the next time you have a headache so you can be examined." is not the best instruction by the nurse to gather additional data before the appointment. It is a suggestion for urgent care, but it does not provide any information about the history, pattern, or characteristics of the headaches.

Choice D reason: "Keep track of how many headaches you have before you come in." is not the best instruction by the nurse to gather additional data before the appointment. It is a simple measure of the quantity of the headaches, but it does not provide any information about the quality, severity, or triggers of the headaches.

Choice A reason: Elevating the head of the bed 20 to 30 degrees is an appropriate intervention for a patient who had a craniotomy to relieve increased intracranial pressure. It helps to reduce the venous pressure and improve the cerebral perfusion.

Choice B reason: Maintaining bright lighting in the room to assess bleeding at the surgical site is not an appropriate intervention for a patient who had a craniotomy to relieve increased intracranial pressure. It can increase the sensory stimulation and aggravate the intracranial pressure. The nurse should use dim lighting and monitor the dressing and the drainage system for signs of bleeding.

Choice C reason: Stimulating the patient every half hour to assess changes in level of consciousness is not an appropriate intervention for a patient who had a craniotomy to relieve increased intracranial pressure. It can increase the cerebral metabolic demand and worsen the intracranial pressure. The nurse should assess the level of consciousness using the Glasgow Coma Scale and avoid unnecessary stimulation.

Choice D reason: Allowing the patient to change positions frequently to maintain comfort is not an appropriate intervention for a patient who had a craniotomy to relieve increased intracranial pressure. It can increase the intrathoracic pressure and affect the cerebral blood flow. The nurse should limit the patient's movement and avoid extreme flexion, extension, or rotation of the head and neck.