Prepare for your NCLEX-RN® exam with a clinical question about discharge teaching for clients recovering from an epidural hematoma!

The nurse in the neurology unit is providing discharge teaching to a client who was treated for an epidural hematoma following a syncopal episode. Which statement by the client indicates further teaching is required?  

A. “If my headaches get bad, I’ll take ibuprofen.”

B. “I’ve scheduled my rehabilitation appointment for next week.”

C. “I’ll call my health care provider if I’m unusually sleepy.”

D. “I’ll remove small area rugs in my home so I don’t fall again.”

Scroll down for the correct answer!

The correct answer to today’s NCLEX-RN® question is…

A. “If my headaches get bad, I’ll take ibuprofen.”

Rationale: This statement requires further teaching. The nurse should remind the client to avoid any medication that can interfere with blood clotting, including aspirin, ibuprofen, and naproxen. If the client has a headache, they should notify their health care provider for reassessment and for a possible alternative medication.

Major Takeaway

When teaching a client with an epidural or subdural hematoma, the nurse should explain that an intracranial hemorrhage can result in a hematoma, where the blood becomes trapped under the membrane that covers the brain, causing pressure on the brain. Then, the nurse should review their plan of care, including their prescribed medications. The nurse should remind them to avoid medication that can interfere with blood clotting, including aspirin, ibuprofen, and naproxen. Also, the nurse should review the recovery plan and allow plenty of time for them to ask questions. The nurse should emphasize the importance of participating in rehabilitation, including occupational, speech, physical therapy, and psychosocial counseling, and remind them to keep all scheduled follow-up appointments. The nurse should also teach the client about lifestyle modifications recommended by their healthcare provider. The nurse should emphasize safety precautions to prevent falls, such as avoiding small area rugs in the home, wearing a helmet during biking, and taking measures to prevent injury during sports. Finally, the nurse should encourage the client to notify the health care provider immediately if they experience increased drowsiness, headaches, visual changes, nausea, vomiting, or behavioral changes.

Intracranial Hemorrhage to Hematoma - Plans of recovery, questions - Avoid medications that can interfere with clotting: aspirin, ibuprofen, naproxen - Importance of participating in rehabilitation: Occupational therapy, speech therapy, physical therapy, psychological counseling
Lifestyle modifications recommend by HCP: Safety precautions to prevent falls like avoiding throw rugs, wearing a helmet during biking, avoid injury during sports. Report to HCP immediately if: Drowsiness, headaches, visual changes, nausea, vomiting, behavioral changes

Incorrect Answer Explanations

B. “I’ve scheduled my rehabilitation appointment for next week.”

Rationale: This statement does not require further teaching. The nurse should emphasize the importance of participating in rehabilitation, which could include occupational, speech, and physical therapy, as well as psychosocial counseling, and remind them to keep all scheduled follow-up appointments.

C. “I’ll call my health care provider if I’m unusually sleepy.”

Rationale: This statement does not require further teaching. The client should be encouraged to report increased drowsiness to the health care provider as this could indicate an increase in intracranial pressure.

D. “I’ll remove small area rugs in my home so I don’t fall again.”

Rationale: This statement does not require further teaching. The client should be taught about safety precautions to prevent falls, such as avoiding small area rugs in their home.

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