A male client is admitted to the stroke rehabilitation unit and is demonstrating right homonymous hemianopsia. The practical nurse (PN) observes that the client only eats the foods on the left side of the plate and tray. Which is the best action for the PN to use with this client to compensate for the visual field deficit?

Choice A reason: Aldosterone is a hormone produced by the adrenal cortex that helps regulate sodium and potassium levels in the body. While aldosterone levels can indicate adrenal function, they are not as commonly used as cortisol levels in diagnosing adrenal cortex failure. Aldosterone regulation is also influenced by the renin-angiotensin-aldosterone system, making it a less direct indicator of overall adrenal cortex function compared to cortisol.
Choice B reason: Cortisol is a glucocorticoid hormone produced by the adrenal cortex and plays a vital role in regulating metabolism, immune response, and stress. Measuring cortisol levels is a primary method for assessing adrenal cortex function. Low cortisol levels can indicate adrenal insufficiency or failure, such as in conditions like Addison's disease. Evaluating cortisol levels provides a direct assessment of the adrenal gland’s ability to produce essential hormones necessary for the body's normal functioning.
Choice C reason: Thyroxine (T4) is a hormone produced by the thyroid gland, not the adrenal cortex. It plays a crucial role in regulating metabolism, growth, and development. While thyroxine levels are important for thyroid function assessment, they do not directly reflect the functioning of the adrenal gland. Therefore, thyroxine levels are not relevant in diagnosing adrenal cortex failure.
Choice D reason: Insulin is a hormone produced by the pancreas and is essential for regulating blood glucose levels. It is not related to the adrenal cortex. Monitoring insulin levels is important for diagnosing and managing diabetes mellitus but does not provide information about the functioning of the adrenal gland. Insulin levels are not used to assess adrenal cortex function.

Choice A reason: This response provides the client with reassurance about hair regrowth after chemotherapy. It acknowledges that while hair loss due to chemotherapy is a common side effect, it is usually temporary. By informing the client that hair loss is not permanent, the PN helps alleviate some of the client's anxiety and fear associated with the treatment. Additionally, the response prepares the client for the possibility that the color and texture of the regrown hair may be different. This information helps manage the client's expectations and provides a more comprehensive understanding of what to expect post-treatment.
Choice B reason: Stating that "we can never tell" is not the most supportive or informative response. While it is true that individual responses to chemotherapy can vary, this answer does not provide the client with any specific information or reassurance. It may leave the client feeling uncertain and anxious about the outcome. The PN's role is to provide clear and accurate information to help the client understand and cope with the effects of treatment. A more informative and empathetic response, such as choice A, is more appropriate in this context.
Choice C reason: While acknowledging that wigs are available is practical, it is not the most reassuring response. The focus on the possibility that hair might not grow back can be disheartening for the client. It is important to offer hope and positivity where possible. By emphasizing that hair loss is usually not permanent and discussing the potential changes in hair color and texture, the PN can provide a more balanced and supportive response. If the client does have concerns about wigs, this can be addressed in a separate discussion.
Choice D reason: Indicating that hair regrowth depends on the amount of drug received is somewhat accurate but lacks the reassurance and positivity provided in choice A. It is important to give the client a clearer understanding that, in most cases, hair loss from chemotherapy is temporary, and hair will generally grow back. This helps alleviate some of the stress associated with the treatment and provides a more hopeful outlook. The amount of drug and specific treatment regimens can be discussed further if the client has additional questions.