A nurse is assisting in the care of a client who is scheduled for surgery.

Exhibits

The nurse is reviewing the client's medical record. Which of the following findings places the client at risk for delayed wound healing. Select all that apply.

A. Instruct the client to blink his eyes as a response: Expressive aphasia affects a person's ability to speak or write, but comprehension is often intact. Encouraging nonverbal communication methods such as blinking for "yes" or "no" responses can help the client effectively express needs and participate in care decisions without requiring speech.

B. Increase voice volume when speaking to the client: Raising the volume does not assist clients with expressive aphasia, as their difficulty lies in expression rather than hearing. Speaking louder can be perceived as frustrating or disrespectful and may not improve understanding or communication for the client.

C. Avoid using hand gestures: Hand gestures and facial expressions can enhance communication for individuals with aphasia by providing visual cues. Avoiding gestures removes a valuable tool that may help the client interpret and respond to messages, especially when they cannot verbalize thoughts.

D. Enunciate words slowly: While speaking clearly is beneficial in many communication disorders, expressive aphasia primarily impairs output, not comprehension. Enunciating slowly may not help the client respond more effectively and is more useful in receptive or global aphasia cases.

A. An assistive personnel is late for the upcoming shift: Tardiness is an issue of staff performance or scheduling rather than client safety, and it should be addressed through administrative or managerial processes. It does not require an incident report unless it directly results in harm or neglect to a client.

B. A client refuses to eat at mealtime: Client refusal to eat is a common occurrence and is managed through nutritional assessments and care planning. While it should be documented in the medical record, it does not constitute an unusual or adverse event that requires an incident report.

C. A family member is napping in the client's room: A family member resting in the room is not an incident unless it interferes with care or violates facility policy. This situation is not associated with client harm or safety risk, so it does not meet the criteria for incident reporting.

D. A client's bed alarm is malfunctioning: A malfunctioning bed alarm is a safety issue, particularly for clients at risk of falls. It represents a potential hazard that could lead to client injury, making it necessary to complete an incident report to document the problem and prompt timely intervention or equipment repair.