A client diagnosed with trigeminal neuralgia is experiencing intermittent, sudden, severe pain on the left side of the face. The nurse identifies which classification of medications is most effective in treating this pain.

Choice A reason: Natural history of disease is not an approach that explains the factors that allow the reproduction and spread of infectious disease. Natural history of disease is a concept that describes the progression and outcome of disease in the absence of any intervention. It includes stages such as susceptibility, exposure, incubation, prodrome, clinical, recovery, disability, or death.

Choice B reason: Health promotion is not an approach that explains the factors that allow the reproduction and spread of infectious diseases. Health promotion is a process that enables people to increase control over and improve their health. It involves strategies such as education, advocacy, policy, or community development.

Choice C reason: Levels of prevention is not an approach that explains the factors that allow the reproduction and spread of infectious disease. Levels of prevention is a framework that classifies different types of interventions based on their timing and purpose. It includes primary prevention (before disease occurs), secondary prevention (early detection and treatment), and tertiary prevention (reducing complications and disabilities).

Choice D reason: Epidemiologic triangle is an approach that explains the factors that allow the reproduction and spread of infectious disease. Epidemiologic triangle is a model that identifies three essential components of an infectious disease: agent (the microorganism that causes the disease), host (the person or animal that is infected), and environment (the physical, biological, or social factors that influence the transmission). The interaction and balance among these components determine the occurrence and spread of an infectious disease.

Choice A reason: Performing carotid massage is not an appropriate action for a nurse to take when a client has signs of a stroke, as it may worsen the condition or cause complications. Carotid massage is a technique that involves applying pressure to the carotid artery in the neck to stimulate the vagus nerve and slow down the heart rate. It is used to treat some types of arrhythmias, such as supraventricular tachycardia. However, carotid massage may dislodge a blood clot or plaque from the carotid artery and cause an embolic stroke, which is a type of ischemic stroke that occurs when a blood clot travels to the brain and blocks a blood vessel. Carotid massage may also cause bradycardia, hypotension, or syncope, which can reduce the blood flow to the brain and worsen the ischemic damage.

Choice B reason: Calling for help is an appropriate action for a nurse to take when a client has signs of a stroke, as it initiates the emergency response and allows for prompt evaluation and treatment. Stroke is a medical emergency that occurs when the blood supply to a part of the brain is interrupted, causing brain cells to die. The sooner the stroke is recognized and treated, the better the chances of survival and recovery. Therefore, the nurse should call for help as soon as possible and activate the stroke protocol in the facility.

Choice C reason: Providing the client with water to test the gag reflex is not an appropriate action for a nurse to take when a client has signs of a stroke, as it may cause aspiration or choking. A gag reflex is an involuntary contraction of the throat muscles that prevents foreign objects from entering the airway. It is tested by touching the back of the throat with a tongue depressor or a cotton swab. However, this test is not indicated in a client who has signs of a stroke, as it may trigger vomiting or coughing, which can increase intracranial pressure or cause bleeding. Moreover, giving water to a client who has signs of a stroke may be dangerous, as they may have dysphagia (difficulty swallowing) or facial weakness, which can impair their ability to swallow safely and increase the risk of aspiration pneumonia.

Choice D reason: Administering thrombolytics is not an appropriate action for a nurse to take when a client has signs of a stroke, as it may be contraindicated or harmful depending on the type and timing of the stroke. Thrombolytics are medications that dissolve blood clots and restore blood flow. They are used to treat ischemic stroke, which is caused by a blood clot that blocks a blood vessel in the brain. However, thrombolytics are not effective for hemorrhagic stroke, which is caused by bleeding into or around the brain. In fact, thrombolytics may worsen hemorrhagic stroke by increasing bleeding and intracranial pressure. Therefore, thrombolytics should only be given after confirming the type of stroke by imaging tests such as computed tomography (CT) scan or magnetic resonance imaging (MRI). Thrombolytics should also be given within a specific time window after the onset of symptoms, usually within 3 to 4.5 hours, as they may lose their effectiveness or cause complications if given too late. Therefore, administering thrombolytics is not an action that a nurse can take without proper assessment and orders from the health care provider.