A nurse is providing teaching to the parent of a newborn. Which of the following statements made by the parent indicates an understanding of the teaching?

Orthostatic hypotension is defined by a systolic decrease of ≥20 mmHg or a diastolic decrease of ≥10 mmHg upon standing. This condition stems from autonomic failure or hypovolemia, leading to inadequate cerebral perfusion and a high risk for falls or syncopal episodes.

A. Administering a diuretic is contraindicated in orthostatic hypotension because it promotes diuresis and further reduces intravascular volume. Lowering the blood volume would exacerbate the drop in pressure when the client stands. This could lead to severe hypovolemic shock or increased frequency of fainting spells.

B. While increasing sodium intake can help expand extracellular fluid volume in some chronic cases, it is not an immediate nursing intervention for a client experiencing the condition. Excessive sodium can also lead to complications like hypertension or edema. It requires medical oversight rather than being a primary intervention.

C. Caffeinated beverages are generally not recommended as a primary treatment for orthostatic hypotension. While caffeine causes temporary vasoconstriction, its diuretic effect can eventually lead to fluid loss. Reliance on stimulants does not address the underlying baroreceptor reflex dysfunction that typically causes the postural drop.

D. Encouraging the client to change positions slowly allows the autonomic nervous system more time to compensate for the gravitational shift of blood. Gradual movement prevents the sudden pooling of blood in the lower extremities. This nursing action is the most effective way to maintain cerebral perfusion and safety.

Effective therapeutic communication with clients experiencing sensory deficits requires environmental modifications and specific behavioral adjustments to ensure the accurate transmission of information. Hearing loss often necessitates the use of visual cues, such as lip-reading and facial expressions, to supplement the auditory signals that the client is struggling to process.

A. Speaking too loudly or shouting can actually distort sound waves for a client with hearing loss and may be perceived as aggressive or condescending. The nurse should maintain a normal volume with distinct articulation, as over-vocalization often makes it harder for the client to decipher individual words and phonemes.

B. Facing the client directly ensures that the nurse’s mouth is visible, allowing the client to utilize non-verbal cues and lip-reading to facilitate understanding. This position also maximizes the projection of sound toward the client, reducing the interference of ambient environmental noise and improving the overall communication flow.

C. High-pitched tones are often the first frequencies lost in age-related hearing impairment, such as presbycusis, making them difficult for many clients to hear. The nurse should use a lower-pitched, natural voice, as lower frequencies travel more effectively through the ear’s conductive and sensorineural pathways in compromised states.

D. While rephrasing can be helpful if a client specifically misunderstands a concept, doing so too frequently can become confusing and disrupt the conversation's logic. It is more effective to use simple, direct language while facing the client rather than constantly changing the vocabulary used to describe clinical care.