A nurse is teaching a newly licensed nurse about contributing factors that can lead to the development of conduct disorder.
Which of the following factors related to family dynamics should the nurse include in the teaching?

Based on the collected data, the nurse recognizes that the client is most likely exhibiting signs of Stroke as evidenced by Neurological defects and Garbled speech. The symptoms of facial drooping, garbled speech, and high blood pressure are common signs of a stroke. However, it’s important to get a professional medical diagnosis as soon as possible. Please seek immediate medical attention.

Choice A rationale:

Intoxication is a plausible explanation for the client’s symptoms, especially given the report of alcohol consumption. However, intoxication typically does not cause facial drooping, which is a common sign of neurological issues such as a stroke. Therefore, while intoxication may contribute to the client’s condition, it is not the most likely primary cause.

Choice B rationale:

Stroke is a medical emergency that often presents with facial drooping and garbled speech, both of which are observed in this client. A stroke occurs when blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. This can lead to brain cells dying in minutes. The client’s high blood pressure (210/98 mm Hg) is a significant risk factor for stroke. Normal blood pressure ranges from 90/60 mm Hg to 120/80 mm Hg.

Choice C rationale:

An allergic reaction could cause various symptoms, but it typically does not result in facial drooping or garbled speech. Common signs of an allergic reaction include hives, itching, redness, and swelling of the skin, as well as difficulty breathing in severe cases (anaphylaxis). There is no mention of these symptoms in the client’s presentation.

Choice D rationale:

Malignant hypertension is a possibility given the client’s extremely high blood pressure reading. This condition refers to severe hypertension that can quickly lead to organ damage. However, while it can cause neurological symptoms if it leads to a hypertensive crisis, the specific symptoms of facial drooping and garbled speech are more indicative of a stroke. In conclusion, based on the collected data, the nurse recognizes that the client is most likely exhibiting signs of a stroke as evidenced by neurological defects (facial drooping and garbled speech). The client’s high blood pressure and reported alcohol consumption are both risk factors for stroke. Immediate medical intervention is crucial to minimize brain damage and potential complications.

Choice A rationale:

Exenatide does not work in the same way as insulin in lowering blood glucose levels. Exenatide is a glucagon-like peptide-1 receptor agonist (GLP-1 agonist) that works by stimulating insulin secretion in response to elevated blood glucose levels, slowing gastric emptying, and suppressing glucagon release. It does not act like exogenous insulin.

Choice B rationale:

Injecting exenatide within 30 minutes before or after a meal is the correct instruction. This timing is essential because exenatide works best when it is coordinated with meals to help control post-meal blood glucose spikes.

Choice C rationale:

There are precautions about taking exenatide with other medications. It is important for the client to discuss all medications, including potential interactions, with their healthcare provider. Some medications may need to be adjusted when taken with exenatide.

Choice D rationale:

Notifying the healthcare provider if abdominal pain occurs is a valid instruction. Exenatide can sometimes cause gastrointestinal side effects, including abdominal pain. It is essential for the client to report any adverse effects to their healthcare provider for appropriate management.