A nurse is caring for a client who had a stroke and coughs frequently when swallowing. The nurse should request a referral to which of the following members of the interdisciplinary team?

Occupational therapist

Physical therapist

Speech-language pathologist

Social worker

Answer and Explanation

The Correct Answer is C

A. Occupational therapist:

While occupational therapists play a valuable role in stroke rehabilitation, they typically focus on activities of daily living (ADLs), upper extremity function, and adaptive strategies. In the context of frequent coughing during swallowing, the expertise of an SLP is more directly relevant to address potential dysphagia.

B. Physical therapist:

Physical therapists primarily focus on mobility, strength, and balance. While they may be involved in stroke rehabilitation, the issue of coughing during swallowing is more aligned with the scope of practice of a speech-language pathologist.

C. Speech-language pathologist:

This is the correct answer. A speech-language pathologist (SLP) specializes in assessing and treating communication and swallowing disorders. In this case, the client is experiencing coughing when swallowing, indicating a potential swallowing (dysphagia) issue. The SLP can conduct a thorough evaluation of the client's swallowing function and recommend appropriate interventions, such as swallowing exercises or modified diets, to address the coughing and improve safe swallowing.

D. Social worker:

Social workers provide support for psychosocial and community-related issues. While they are crucial members of the interdisciplinary team, they may not have the specific expertise needed to address the swallowing difficulties experienced by the client after a stroke

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Correct Answer is D

Explanation

A. Elevate full-length side rails on both sides of the client's bed:

While side rails are used to prevent falls, full-length side rails can pose a risk to the client. They may give a false sense of security, and there's a risk of entrapment or injury if the client tries to climb over them. The use of side rails requires careful assessment and consideration of the individual client's needs.

B. Place the bedside table 0.9 m (3 feet) away from the bed:

Placing the bedside table 0.9 m (3 feet) away from the bed may not directly address the risk of falls. The focus should be on making essential items easily accessible to the client to minimize the need for them to get out of bed, especially during the night. Placing items within the client's reach is a more practical approach.

C. Keep the client's room temperature at 18°C (64.4°F):

While maintaining a comfortable room temperature is important for the client's overall well-being, it is not a direct preventive measure for falls. Falls are more likely to be prevented by addressing environmental factors, ensuring clear pathways, and providing adequate lighting.

D. Provide the client with a night light:

This is the appropriate action. A night light helps improve visibility during nighttime, reducing the risk of falls. It allows the client to see their surroundings better and navigate the room safely if they need to get out of bed.

A. Use an 18-gauge, 1-inch needle to administer the medication. B. Inject 5.1 cm (2 in) away from the umbilicus. C. Expel air bubble before injecting medication. D. Massage the injection site after withdrawing the needle.

Correct Answer is B

Explanation

A. Use an 18-gauge, 1-inch needle to administer the medication.An 18-gauge needle is too large for subcutaneous heparin injections, which require a smaller, finer needle, typically 25- to 27-gauge and ⅜- to ⅝-inch in length. The smaller gauge reduces discomfort and is appropriate for subcutaneous tissue.

B. Inject 5.1 cm (2 in) away from the umbilicus.Heparin injections should be given at least 2 inches from the umbilicus to avoid areas with dense blood vessels, which decreases the risk of hematoma formation and improves medication absorption.

C. Expel air bubble before injecting medication.For prefilled heparin syringes, the small air bubble should not be expelled, as it helps ensure the full dose is administered and can reduce bruising by sealing the medication in the tissue.

D. Massage the injection site after withdrawing the needle.Massaging the site after a heparin injection is not recommended as it increases the risk of bruising and tissue irritation. Instead, gentle pressure may be applied briefly if there is bleeding at the site.

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A nurse is caring for a client who had a stroke and coughs frequently when swallowing. The nurse should request a referral to which of the following members of the interdisciplinary team?

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