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?

Choice A reason: Narrowed pulse pressure is not a specific manifestation of pneumonia in the older adult client. Pulse pressure is the difference between the systolic and diastolic blood pressure readings. A normal pulse pressure is about 40 mm Hg, and a narrowed pulse pressure is less than 25 mm Hg. A narrowed pulse pressure can indicate various conditions, such as heart failure, shock, or aortic stenosis, but it is not a sign of pneumonia.

Choice B reason: Night sweats are not a common manifestation of pneumonia in the older adult client. Night sweats are episodes of excessive sweating during sleep that can soak the bedding or clothing. Night sweats can have many causes, such as menopause, infections, medications, or cancer, but they are not typically associated with pneumonia.

Choice C reason: Bradycardia is not a usual manifestation of pneumonia in the older adult client. Bradycardia is a slow heart rate, defined as less than 60 beats per minute. Bradycardia can be normal in some people, such as athletes or those who are very fit, or it can be a sign of a problem with the heart's electrical system. Pneumonia does not cause bradycardia, but it can cause tachycardia, which is a fast heart rate, due to the increased oxygen demand and inflammation.

Choice D reason: Confusion is a frequent manifestation of pneumonia in the older adult client. Confusion is a state of impaired awareness, orientation, memory, or judgment. Confusion can occur in older adults with pneumonia due to several factors, such as hypoxia, dehydration, electrolyte imbalance, fever, or infection. Confusion can also increase the risk of complications, such as aspiration, falls, or delirium. Therefore, the nurse should monitor the mental status of the older adult client with pneumonia and report any changes to the provider..

Choice A reason: Encourage brief exercise before meals to promote appetite. This answer is incorrect because exercise before meals can increase fatigue and decrease appetite in some clients with dysphagia. Exercise can also affect the blood flow to the brain and the muscles involved in swallowing .

Choice B reason: Encourage the client to take small bites. This answer is correct because taking small bites can help the client swallow more easily and reduce the risk of choking or aspiration.

Choice C reason: Place the client with the head reclined back to facilitate swallowing. This answer is incorrect because placing the client with the head reclined back can impair the swallowing mechanism and increase the risk of aspiration. The client should be placed with the head tilted slightly forward to help the food move down the throat.

Choice D reason: Place food in the affected side of the mouth. This answer is incorrect because placing food in the affected side of the mouth can cause the food to remain in the mouth and not be swallowed properly. The client should be encouraged to use both sides of the mouth to chew and swallow food.