A nurse is caring for a client who has impaired speech. Which of the following actions should the nurse take?

Choice A reason : Determining the success of coping strategies is an important part of the nursing process, but it is not the first step when caring for a client experiencing grief. The initial step should be to assess the client's current state, including their grieving process, before evaluating the effectiveness of past coping strategies.

Choice B reason : Establishing whether the client's grieving is healthy or complicated is the first action the nurse should take according to the nursing process. This assessment helps to identify the client's needs and guides the subsequent planning of care. Healthy grieving is a natural response to loss, whereas complicated grief may require more intensive intervention and support.

Choice C reason : Developing client-specific goals and outcomes is a crucial part of the nursing process but should come after the nurse has established a clear understanding of the client's grieving process. Goals and outcomes should be based on the initial assessment and tailored to the client's individual situation.

Choice D reason : Incorporating the treatment into the client's care is part of the implementation phase of the nursing process. This step occurs after the nurse has assessed the client, established goals, and planned interventions. Treatment should be based on a thorough understanding of the client's grieving process.

Choice A reason : Asthma is a chronic condition characterized by respiratory symptoms such as wheezing, shortness of breath, and coughing due to airway inflammation and constriction. While genetic and environmental factors contribute to the development of asthma, there is no direct correlation between advanced maternal age and an increased risk of asthma in offspring. Asthma's etiology is multifactorial and more closely related to family history, exposure to allergens, and respiratory infections during early childhood.

Choice B reason : Spina bifida is a neural tube defect that occurs when the spine and spinal cord don't form properly. It's associated with factors such as folic acid deficiency during early pregnancy, certain medications, diabetes, and obesity. Although advanced maternal age may slightly increase the risk of chromosomal abnormalities, it is not considered a significant risk factor for spina bifida. Adequate intake of folic acid before conception and during early pregnancy is the most effective prevention strategy.

Choice C reason : Down syndrome is a genetic disorder caused by the presence of an extra copy of chromosome 21 (trisomy 21). The risk of conceiving a child with Down syndrome increases with maternal age, particularly after age 35. This is due to the higher likelihood of nondisjunction events during cell division in older eggs, leading to an abnormal number of chromosomes. Advanced maternal age is a well-established risk factor for Down syndrome, and prenatal screening is recommended to assess the risk.

Choice D reason : Facial malformations, such as cleft lip or palate, are congenital anomalies that can affect the appearance and function of a child's face. These conditions are influenced by genetic and environmental factors, including certain medications, nutritional deficiencies, and exposure to harmful substances during pregnancy. While advanced maternal age may contribute to an increased risk of chromosomal abnormalities, it is not specifically linked to an increased risk of isolated facial malformations.