The nurse is caring for a client with a history of Parkinson’s disease. Which intervention should the nurse prioritize?

Choice A reason: Over-enunciating syllables emphasizes pronunciation, which may help with clarity but does not directly address hearing impairment. Age-related hearing loss (presbycusis) often involves difficulty processing rapid speech. Slowing speech is more effective, as over-enunciation may distort natural speech patterns, reducing comprehension in older adults with hearing deficits.

Choice B reason: Shouting increases volume but can distort speech and cause discomfort, worsening communication for those with presbycusis. High-frequency hearing loss in older adults makes loud sounds less effective, as they struggle with pitch discrimination. Slower, clear speech better facilitates understanding than shouting, which may also seem aggressive.

Choice C reason: Decreasing speaking speed enhances comprehension in older adults with hearing loss. Presbycusis impairs processing of rapid speech, particularly high-frequency sounds. Slow, clear speech allows more time for auditory processing, improving understanding without distorting sound or relying on less effective nonverbal cues, making it the optimal intervention.

Choice D reason: Exaggerating nonverbal expressions relies on visual cues, which does not address auditory comprehension. While gestures may supplement communication, they are insufficient for conveying detailed medical questions. Hearing-impaired clients primarily need auditory adjustments, like slower speech, to process verbal information effectively, making nonverbal exaggeration less appropriate.

Choice A reason: Rinsing the mouth after using a corticosteroid inhaler prevents oral candidiasis, a common side effect from residual steroid deposition. This ensures safe asthma management, as fungal infections compromise adherence and health, making it the priority teaching point for proper inhaler use.

Choice B reason: Using the inhaler only during asthma attacks applies to rescue inhalers, not maintenance corticosteroids, which are used daily. This is incorrect, as rinsing the mouth is essential for corticosteroid inhalers to prevent oral thrush, ensuring safe and effective asthma control.

Choice C reason: Storing inhalers in a refrigerator is unnecessary and may degrade some medications. Room-temperature storage is standard. Rinsing the mouth after corticosteroid inhaler use is critical to prevent oral candidiasis, making it the priority teaching point for asthma management.

Choice D reason: Shaking the inhaler only once may be insufficient for proper aerosolization in some devices. Rinsing the mouth after corticosteroid inhaler use is the priority, as it prevents oral thrush, a significant side effect, ensuring safe and consistent asthma therapy.