A nurse is working with many stroke clients. Which clients would the nurse consider referring to a mental health provider on discharge? (Select all that apply.)
a. Client who exhibits extreme emotional lability
b. Client with an initial National Institutes of Health (NIH) Stroke Scale score of 38
c. Client with mild forgetfulness and a slight limp
d. Client who has a past hospitalization for a suicide attempt
e. Client who is unable to walk or eat 3 weeks post-stroke
ANS: A, B, D, E
Clients most at risk for post-stroke depression are those with a previous history of depression, severe stroke (NIH Stroke Scale score of 38 is severe), and post-stroke physical or cognitive impairment. The client with mild forgetfulness and a slight limp would be a low priority for this referral.
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