In assessing a male client's level of consciousness, the nurse determines that the client does not open his eyes spontaneously. Which should the nurse do next?

To determine the Apgar score for the newborn infant, we assess five parameters: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Each parameter is scored from 0 to 2, with 2 being the highest score. Let's evaluate each parameter:

1. Heart rate: 150 beats/minute --> Score of 2.
2. Respiratory effort: Vigorous cry present --> Score of 2.
3. Muscle tone: Good muscle tone with total flexion --> Score of 2.
4. Reflex irritability: Quick reflex irritability noted --> Score of 2.
5. Color: Dusky and cyanotic skin color --> Score of 1.

Now, we sum up the scores: 2+2+2+2+1=92+2+2+2+1=9

Therefore, the Apgar score for this infant is 9.

A. Stand behind the client to avoid intimidation. This is not an appropriate teaching strategy. Standing behind a client can actually increase intimidation and anxiety, as it does not allow for direct eye contact and clear communication.

B. Turn on overhead lights while giving instructions. Proper lighting is essential for older adults, who may have visual impairments. Turning on overhead lights ensures that the client can clearly see the materials and the nurse, enhancing understanding and engagement during the teaching session.

C. Provide handouts written at a 12th grade reading level. Handouts for patient education should be written at a lower reading level, generally around the 5th to 6th grade level, to ensure comprehension by a broad audience, including those with limited literacy skills. A 12th grade reading level is too high for effective patient education for most adults.

D. Use background music to promote relaxation. Background music can be distracting rather than relaxing during educational sessions, especially for older adults who may have hearing impairments or cognitive issues. Clear and focused communication is more effective without additional auditory distractions.