The nurse is caring for the client who has dysphagia following an ischemic stroke. The client is ordered a pureed diet starting today. Which intervention would be appropriate for this client?

Delegate the feeding to the nursing student.

Place the food on the affected side of the mouth.

Keep the television off while feeding the client.

Ensure the client's head of the bed is less than 30 degrees.

Answer and Explanation

The Correct Answer is C

A.   While the nursing student may assist with feeding, the nurse should always assess the client's swallowing ability and provide direct supervision to ensure the client's safety.
B.   Placing food on the affected side of the mouth can increase the risk of aspiration. The food should be placed on the unaffected side of the mouth.
C.   Distractions can impair the client's ability to focus on swallowing and increase the risk of aspiration. A quiet environment can help the client concentrate on eating.
D.   The head of the bed should be elevated to at least 30 degrees during and after feeding to reduce the risk of aspiration.

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Correct Answer is D

Explanation

A. While it's true that ulcers can be a serious complication of PAD and require careful management, exercise is generally encouraged in patients with PAD as long as it is safe and supervised. Patients should consult their healthcare provider about appropriate exercise, but not exercising altogether can worsen their condition.
B. Buying shoes in the afternoon is advisable because feet can swell throughout the day. It helps ensure a better fit and reduces the risk of blisters or skin breakdown, which is particularly important for clients with PAD.
C. This statement is generally correct, as dangling the legs can help improve circulation in some cases. Clients with PAD often experience relief when their legs are in a dependent position, as it may help increase blood flow to the extremities. However, they should also be encouraged to avoid prolonged periods of sitting.
D. This statement may indicate a misunderstanding. Compression stockings are typically used for venous issues rather than arterial diseases like PAD. In patients with PAD, wearing compression stockings may not be appropriate and could potentially compromise arterial blood flow.

A. A career as a corporate attorney who exercises three times per week B. An uncomplicated vaginal birth 12 years ago C. Drinking a glass of red wine with dinner and taking Yoga classes on Saturdays D. Taking birth control pills and a 15-year pack per day smoking habit

Correct Answer is D

Explanation

A. This choice suggests a high-stress job but includes a positive aspect—regular exercise. Regular physical activity is protective against stroke, and being active can help mitigate some risk factors. Therefore, this scenario does not indicate a high risk for stroke.
B. This choice does not present a significant risk factor for stroke. An uncomplicated vaginal birth is typically not associated with an increased risk of stroke. Factors like recent pregnancy could increase risk due to changes in blood coagulation, but 12 years post-birth is not relevant.
C. Moderate alcohol consumption, such as a glass of red wine, may have some cardiovascular benefits when done in moderation, and practicing yoga can be beneficial for stress reduction and overall health. Therefore, this option does not suggest a high risk for stroke.
D. Both smoking and the use of birth control pills significantly increase the risk of stroke, particularly in women. Smoking is a well-known risk factor for cardiovascular disease and can lead to thrombosis (blood clots).

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