A nurse is teaching a client who has a new prescription for sumatriptan (Imitrex) tablets to treat migraine headaches. Which of the following instructions should the nurse include?

Choice A reason: Nurses performing duties outside of the nurses' typical job description is a component that should include nurses. In a disaster situation, nurses may have to assume roles and responsibilities that are beyond their usual scope of practice, such as triage, first aid, or mass casualty management. Nurses should be trained and prepared to perform these duties safely and effectively.

Choice B reason: A plan for comprehensive practice drills is a component that should include nurses. Practice drills are essential for testing and improving the disaster plan, as well as enhancing the skills and confidence of the staff. Nurses should participate in regular and realistic drills that simulate different types of disasters and scenarios.

Choice C reason: Identification of resources to meet anticipated needs for food, water, and supplies is a component that should include nurses. In a disaster situation, the demand for resources may exceed the supply, and the availability of resources may be disrupted or limited. Nurses should be involved in identifying and prioritizing the essential resources that are needed to provide care and support to the clients and staff.

Choice D reason: An internal and external communication plan is a component that should include nurses. In a disaster situation, communication is vital for coordinating actions, sharing information, and providing updates. Nurses should be aware of the communication channels and protocols that are used within and outside the hospital, such as radios, phones, or social media.

Choice E reason: Discharge all surgical clients who are one day or more post-op is not a component that should include nurses. This is not a realistic or appropriate strategy for reducing the hospital's occupancy or workload in a disaster situation. Discharging surgical clients who are still recovering may compromise their health outcomes and increase their risk of complications or readmission.

Choice A reason: Monitoring vital signs and neurological status frequently is a priority intervention for a client who has experienced a hemorrhagic stroke, as it helps to detect any changes in the client's condition and guide appropriate treatment. Hemorrhagic stroke is a medical emergency that occurs when a blood vessel in the brain ruptures and causes bleeding into the brain tissue. This can lead to increased intracranial pressure, cerebral edema, and brain damage. Therefore, the nurse should monitor the client's blood pressure, pulse, respiration, temperature, level of consciousness, pupil reaction, motor function, and sensory function frequently and report any abnormalities to the health care provider.

Choice B reason: Maintaining strict bed rest to minimize cerebral blood flow is not a priority intervention for a client who has experienced a hemorrhagic stroke, as it may not prevent further bleeding or improve the client's outcome. In fact, strict bed rest may increase the risk of complications such as deep vein thrombosis, pulmonary embolism, pneumonia, pressure ulcers, and muscle atrophy. The nurse should follow the health care provider's orders regarding the client's activity level and position. The nurse should also provide adequate hydration, nutrition, skin care, and comfort measures to the client.

Choice C reason: Administering anticoagulant medications as prescribed is not a priority intervention for a client who has experienced a hemorrhagic stroke, as it may worsen the bleeding and increase the risk of intracranial hemorrhage. Anticoagulant medications are used to prevent or treat ischemic stroke, which is caused by a blood clot that blocks a blood vessel in the brain. However, anticoagulant medications are contraindicated in hemorrhagic stroke, as they interfere with the blood's ability to clot and stop the bleeding. The nurse should avoid giving any medications that may affect coagulation or platelet function to the client unless ordered by the health care provider.

Choice D reason: Assisting the client with active range of motion exercises is not a priority intervention for a client who has experienced a hemorrhagic stroke, as it may not improve the client's neurological function or prevent complications. Active range of motion exercises are performed by the client with or without assistance from the nurse to maintain joint mobility and muscle strength. However, these exercises are not indicated in the acute phase of hemorrhagic stroke, as they may increase intracranial pressure or cause pain or discomfort to the client. The nurse should consult with the physical therapist before initiating any exercise program for the client.