The nursing assistant reports that the hearing-impaired client is alert and oriented with the hearing aid in place but the client does not respond to verbal communication this morning. Which should the nurse implement first?

Question

1. Document that the client's neurological status is poor.
2. Assess the client for clinical indicators of a stroke.
3. Remove the hearing aid and clean it with a stiff brush.
4. Instruct nursing assistant to check hearing aid battery.

Answer 1

4
4. Because the client is alert and oriented, the nurse realizes the most likely cause of the client's change in hearing is a defective hearing aid battery. The nurse directs the assistant to check the battery first because this is also a simple factor to eliminate.
1. The nurse does not know yet whether the client's neurological status is poor; the nurse only knows the client's hearing is impaired with the hearing aid in place.
2. The nursing assistant reports clinical indicators of normal neurological function, making a stroke unlikely.
3. After checking the batteries, the nurse instructs the assistant to clean the hearing aid with the brush supplied by the manufacturer, which is the brush the client uses regularly.