Final answer:
The nurse should directly engage with the client with expressive aphasia using simple questions, non-verbal cues, and by observing non-verbal communication, while also including speech-language therapy in the care plan.
Step-by-step explanation:
In a case where a 50 year old client has difficulty with communication due to expressive aphasia after a Cerebrovascular Accident (CVA), also known as a stroke, it is crucial for the nurse to use effective communication strategies. Since the spouse is responding for the client, the nurse should first acknowledge the spouse's input to ensure their perspectives and concerns are heard. However, the nurse should also directly engage with the client, as individuals with expressive aphasia are often able to understand language even though they have difficulty speaking.
The strategy includes using simple, yes-or-no questions, allowing ample time for the client to respond, and using non-verbal cues such as gestures. The nurse should also pay close attention to the client's non-verbal communication, such as facial expressions and body language, which might provide additional insight into the client's feelings and needs.
Ultimately, the goal is to support the client's autonomy and active participation in their care. Involving speech-language therapy as part of the recovery plan can also be beneficial, focusing on exercises and techniques that can help improve the client's ability to express themselves over time.