Mr

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Mr. Mendes is an 81-year-old man who speaks only Portuguese. He is quite frail, weighing only 110 pounds. He had a below-the-knee amputation of his left leg two weeks ago. Mr. Mendes has been admitted to the hospital from a rehabilitation center with an acute change in mental status and diminished lung sounds in the left base. Mr. Mendes is diagnosed with left lower lobe pneumonia and antibiotic therapy is pre- scribed. The nurse assigned to care for Mr. Mendes does not speak Portuguese. 

Mr. Mendes requires complete an assistance with activities of daily living (ADLs). A medical interpreter is not assigned to the nursing unit; but, if needed, the nurse can ask a Portuguese-speaking nursing staff member to help interpret what Mr. Mendes is trying to express. However, the nurse still must develop a way of communicating with Mr. Mendes so the nurse can assess Mr. Mendes's level of comfort, provide care, and identify any needs. 

1. Briefly discuss the challenges of developing a nurse-client relationship when a language barrier exists between the client and nurse. 

2. Explain the difference between a medical "interpreter" and a medical "translator." 

3. Family members are often willing to interpret for the client and are more readily available. Discuss the use of medical interpreters and why, legally and ethically, family members (or friends of the client) are not the preferred interpreter(s). 

4. Describe a therapeutic nurse-client relationship. 

5. The nurse nonverbal strategies the nurse can implement to help develop a therapeutic relationship with Mr. Mendes. 

6. Provide the most likely explanation for why Mr. Mendes presented with an acute change in mental status. 

does not speak Portuguese. Discuss 

7. Briefly discuss how Mr. Mendes's past medical history relates to his below-the-knee leg amputation. What is the benefit of having a below-the-knee (B-K) amputation versus an above-the-knee (A-K) amputation? 

8. The interpreter tells the nurse that Mr. Mendes would like the nurse to remove the bed linens from his left foot and raise his leg on pillows. He states, "My foot aches and maybe if you put it up it on some pillows will feel better." Provide a rationale for Mr. Mendes's request. Should the nurse elevate his stump on pillows as requested? Why or why not? 

9. Mr. Mendes has not yet been fit for a prosthesis. The nurse provides care of his stump. Briefly discuss the nursing interventions involved in stump care. What outcome goals does the nurse hope to achieve through proper stump care? 

10. List five nursing diagnoses appropriate to consider for Mr. Mendes's plan of care.