An unlicensed assistive personnel (UAP) reports that a client's right hand and fingers spasm when taking the blood pressure using the same arm.

After confirming the presence of the spasms, which action should the nurse take?

Choice A rationale:

A Speech Therapist is crucial in this case. The patient presented with garbled speech, which indicates a possible speech impairment. A speech therapist can evaluate the patient’s speech and language skills and provide therapy to improve any deficits, which can significantly enhance the patient’s quality of life.

Choice B rationale:

A Case Manager is essential in coordinating the patient’s care. They ensure that the patient’s healthcare needs are met and that the patient is receiving appropriate treatments. They also coordinate with various healthcare professionals and may assist with insurance issues or discharge planning.

Choice C rationale:

A Physical Therapist can help the patient regain physical strength and mobility that might have been affected by the stroke. They can provide exercises and treatments to improve balance, coordination, and muscle strength, which can help the patient regain independence in their daily activities.

Choice D rationale:

A Pharmacy Technician is not typically involved in direct patient care or recovery. Their role is more focused on assisting pharmacists with dispensing medication and other administrative tasks in a pharmacy setting.

Choice E rationale:

The Chief Nursing Officer (CNO) is a high-level executive role that oversees nursing staff across an entire healthcare organization. While they play a crucial role in ensuring quality nursing care, they would not be directly involved in individual patient recovery.

Choice F rationale:

A Respiratory Therapist could be helpful if the patient had respiratory issues or complications related to the stroke, but given the information provided, it does not appear that respiratory therapy is needed in this case.

Choice G rationale:

A Medical Assistant typically performs administrative and clinical tasks in healthcare settings but does not specialize in rehabilitation or recovery care for stroke patients.

Choice H rationale:

An Occupational Therapist is vital for stroke recovery. They can help the patient regain skills needed for daily living activities that might have been affected by the stroke, such as eating, dressing, and bathing. They can also provide strategies to compensate for any lasting deficits from the stroke. In summary, for a comprehensive recovery plan for this patient who has had a stroke, an interdisciplinary team involving a Speech Therapist (A), Case Manager (B), Physical Therapist ©, and Occupational Therapist (H) would be most beneficial.

Choice A rationale:

Diarrhea and flatulence are common side effects of statin medications like lovastatin but are typically not considered emergencies. They may be managed with dietary adjustments or over-the-counter remedies.

Choice B rationale:

Muscle pain, especially if severe, requires the most immediate follow-up by the nurse. Muscle pain can be a symptom of a rare but serious side effect called rhabdomyolysis, which can lead to muscle breakdown and potential kidney damage. Prompt assessment and intervention are necessary if severe muscle pain occurs.

Choice C rationale:

Altered taste is a side effect of lovastatin but is generally not considered a medical emergency. It may affect the client's quality of life but does not require immediate follow-up.

Choice D rationale:

Abdominal cramps may occur as a side effect of lovastatin, but they are not typically considered an emergency. Like choice A, abdominal cramps can often be managed with dietary adjustments or over-the-counter remedies.