Patient Profile:

• Age: 68 years
• Gender: Male
• Medical History: Hypertension, Type 2 Diabetes Mellitus
• Medications: Lisinopril, Metformin
• Allergies: None

Chief Complaint: The patient presents to the emergency department (ED) with sudden onset of right-sided weakness and difficulty speaking that began approximately 1 hour prior to arrival.

Exhibits

Choose three parameters the nurse should monitor to assess the patient's progress.

Choice A reason: Shivering can be a response to various conditions, including cold temperatures or fever, but it is not a direct indicator to discontinue suctioning. While it may be concerning, it does not specifically suggest a problem caused by the suctioning procedure.

Choice B reason: Decreased SpO₂ (oxygen saturation) is a critical sign that the patient is not getting enough oxygen. This condition requires immediate attention, and suctioning should be stopped to assess and address the cause of the hypoxia. Continuing to suction can exacerbate respiratory distress and further lower oxygen levels.

Choice C reason: Absence of coughing is a sign that the patient's airway may be compromised or that the suctioning is too aggressive, potentially leading to further complications. Coughing is a protective reflex that helps clear the airway, and its absence indicates that the airway is not adequately protected, warranting cessation of suctioning.

Choice D reason: Development of dysrhythmias (irregular heartbeats) during suctioning is a serious concern. Dysrhythmias can indicate that the patient is experiencing significant physiological stress or that the vagus nerve is being stimulated, which can impact heart function. Immediate discontinuation of suctioning is necessary to prevent cardiac complications and to stabilize the patient's condition.

Choice E reason: Increased blood pressure, while indicative of stress or pain, is not an immediate indicator to stop suctioning. It should be monitored and addressed, but it does not pose the same immediate risk as decreased oxygen saturation or dysrhythmias.

Choice A reason: Improving public transportation to the clinic would indeed make it easier for residents to access healthcare services. However, this strategy alone does not directly address the cultural and specific health needs of the Hispanic community.

Choice B reason: Obtaining low-cost medications for clinic patients can alleviate some financial burdens and improve access to necessary treatments. While this is beneficial, it does not tackle the root of health disparities related to cultural differences and health beliefs.

Choice C reason: Teaching clinic staff about cultural health beliefs is crucial for reducing health care disparities and promoting health equity. Understanding the cultural background, health beliefs, and practices of the Hispanic community allows healthcare providers to deliver more culturally competent and patient-centered care, building trust and improving health outcomes.

Choice D reason: Updating equipment and supplies at the clinic can enhance the quality of care provided. However, without addressing the cultural competency of the healthcare staff, this strategy does not directly impact health equity or reduce disparities specific to the Hispanic community.