Final answer:
The nurse should initially use behavioral indicators to assess the pain level in a client with expressive aphasia following a CVA, as the client may not be able to communicate pain verbally due to the aphasia.
Step-by-step explanation:
The nurse should use behavioral indicators and effects to assess the client's pain level who has expressive aphasia following a cerebrovascular accident (CVA). Since expressive aphasia affects the ability to communicate verbally, relying on the self-reporting of pain through scales like the Wong-Baker Faces pain-rating scale may not be possible. Observing for non-verbal cues such as grimacing, moaning, restlessness, or changes in vital signs can help determine the client's level of discomfort. This method is particularly useful in cases where language functions are compromised.
Pain is a subjective symptom that is felt by the patient and cannot always be objectively measured, but behavioral indicators can provide valuable insights for pain assessment. When cognitive or language deficits are apparent, as would be the case with someone who has expressive aphasia, healthcare providers must adjust their approach accordingly.
Other assessment methods, such as measuring skin conductance fluctuations, can also supplement observational data to quantify pain levels in patients who cannot communicate their pain effectively.