A nurse is assessing a client who is receiving a blood transfusion. The nurse notes lung crackles, hypoxia, and distended neck veins. Which of the following actions should the nurse take? (Select all that apply.)

A. speech-language pathologist specializes in assessing and treating communication and swallowing disorders. In this case, the client's coughing when swallowing indicates a potential swallowing disorder (dysphagia), which falls within the scope of practice of a speech-language pathologist. They can assess the client's swallowing function, provide appropriate interventions, and work with the client to improve swallowing safety and efficiency.
B. Occupational therapists may be involved in stroke rehabilitation to address activities of daily living (ADLs) but they typically do not specialize in swallowing disorders. Their focus is more on helping individuals regain independence in activities such as dressing, grooming, and cooking.
C. Physical therapists primarily focus on improving mobility, strength, balance, and coordination. While they may be involved in stroke rehabilitation to address physical impairments such as weakness or paralysis, they are not typically the primary referral for managing swallowing disorders.
D. Social workers play a crucial role in addressing the psychosocial and practical needs of clients and their families, such as accessing community resources, counseling, and support. While they may be involved in the overall care of a client who has had a stroke, they do not have the expertise to address swallowing disorders. Therefore, they are not the most appropriate referral in this case.

A. This is a direct and important question to assess the client's immediate risk of self-harm or suicide. It is appropriate because it helps to determine the level of risk and the need for immediate intervention.

Asking about suicidal thoughts can also open up a conversation about the client’s feelings and
experiences.
B. This response shows empathy and encourages the client to share more about their loss, which can be therapeutic. However, it does not directly address the immediate concern of the client's suicidal statement. While understanding the client's grief is important, the nurse first needs to assess the client's current safety.
C. This response might come off as dismissive, implying that the nurse is not willing or able to help the client at that moment. It deflects the client's immediate distress and need for support, which could make the client feel more isolated.
D. While understanding why the client stopped their medication is important, this question does not address the client's current suicidal ideation and distress. The focus should initially be on assessing the risk and providing immediate support before delving into medication adherence.