A nurse is assessing a client who has right-sided heart failure. Which of the following findings should the nurse expect?

A. Using simple language is helpful, but speaking in a childlike manner can be demeaning and may lower the client’s self-esteem. Communication should remain respectful and age-appropriate.

B. Incorporating nonverbal cues such as gestures, facial expressions, pictures, and written words supports understanding. Clients with aphasia often benefit from visual aids and other alternative communication strategies to enhance comprehension.

C. Raising the pitch of the voice does not improve comprehension in aphasia because the issue is related to language processing rather than hearing ability. A normal tone should be maintained unless the client has a hearing impairment.

D. Asking multiple-choice questions can sometimes assist with expressive aphasia; however, relying solely on this method may limit natural communication. The broader and more supportive approach is to incorporate nonverbal communication techniques.

1. A hemorrhagic stroke is a type of stroke that occurs when a blood vessel in the brain ruptures and bleeds into the surrounding tissue. A common cause of hemorrhagic stroke is a cerebral aneurysm, which is a weak or bulging spot in an artery wall. When an aneurysm ruptures, it causes sudden and severe bleeding in the brain, which can damage brain cells and increase intracranial pressure. Symptoms of a hemorrhagic stroke include a sudden and severe headache, often described as "the worst headache of my life", followed by neurologic deficits, such as weakness, numbness, vision loss, speech problems, confusion, or loss of consciousness
2. The other options are not correct because:
3. History of neurologic deficits lasting less than 1 hr. This statement is incorrect because it describes a transient ischemic atack (TIA), which is a temporary interruption of blood flow to the brain that causes brief neurologic symptoms that resolve within 24 hours. A TIA is often a warning sign of an impending ischemic stroke, which is a type of stroke that occurs when a blood clot blocks an artery in the brain and reduces blood flow to the affected area.
4. Maintains consciousness. This statement is incorrect because most clients with hemorrhagic stroke lose consciousness or have altered mental status due to the increased intracranial pressure and brain damage caused by the bleeding. The level of consciousness depends on the location and extent of the hemorrhage, but it usually deteriorates rapidly.
5. Gradual onset of several hours. This statement is incorrect because hemorrhagic stroke usually has a sudden onset, unlike ischemic stroke, which may have a gradual onset over several hours or days. The onset of hemorrhagic stroke is often associated with physical exertion, emotional stress, or hypertension, which can increase the risk of aneurysm rupture.