A nurse is developing a plan of care for a client who is recovering from a stroke and is experiencing dysphagia and right-sided weakness. Which of the following interventions should the nurse include in the plan of care?
Provide a nonskid placemat for the client at meals.
Instruct the client to tilt their head back when swallowing.
Instruct the client to chew food on the right side of their mouth.
Provide narrow-grip utensils during meals.
The Correct Answer is A
A. Providing a nonskid placemat can help prevent spills and accidents during meals, especially for a client with right-sided weakness who may have difficulty with coordination and balance.
B. Instructing the client to tilt their head back when swallowing is not recommended and may increase the risk of aspiration, particularly for a client with dysphagia.
C. Instructing the client to chew food on the right side of their mouth may not be feasible or effective, especially if there is weakness on the right side.
D. Providing narrow-grip utensils may not directly address the client's needs related to dysphagia and right-sided weakness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Hemoglobin levels primarily reflect the oxygen-carrying capacity of red blood cells and are not specific to nutritional status.
B. Transferrin levels reflect iron-binding capacity and may be influenced by factors other than nutrition.
C. Prealbumin levels have a shorter half-life compared to total albumin and can provide a more immediate assessment of nutritional status and the effectiveness of TPN in the short term.
D. Total albumin levels reflect longer-term protein status and may not change significantly in the short term with TPN administration.
Correct Answer is A
Explanation
A. Diarrhea can be a symptom of an allergic reaction to a new food. It may indicate the body's immune response to the food allergen.
B. Bruising, fever, and jaundice are not typically associated with allergic reactions to food in infants. Bruising may be indicative of other issues such as trauma or bleeding disorders.
C. Fever is not a common symptom of food allergies in infants. Fever may indicate an infection or other underlying medical condition unrelated to food allergies.
D. Jaundice is not commonly associated with allergic reactions to food in infants. Jaundice may indicate liver or bile duct problems but is not typically related to food allergies.
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