Question

1) Top 3 priority assessments 2) Priority labs and dx studies 3) Patient education needs 4) Brief patho of main diagnosis 5) Three pertinent nursing diagnos 6) Priority interventions 7) Possible medications that may
for a person with left sided stroke

Answer 1

Left sided stroke

Left side damage causes right side weakness.

Assessment the following :

• Paralyzed right side hemiplegia
• Impaired speech and language ( Alpha inability to speak or understand spoken words
• performance - causes slow performance
• Assess vision -Visual field deficit
• Mental state - left sided stroke causes
• Depression and anxiety
• comprehension ( impaired comprehension )

Diagnostic studies

• Noncontrast CT or brain MRI
• Blood glucose
• Serum electrolyte and renal function test
• Electrocardiogram
• Markers of cardiac ischemia (trop T, trop I etc)
• CBC including platelets
• PT/ INR
• APTT
• Oxygen saturation
• Liver function test

Patient education

• Education regarding stroke which occurs blood supply to to brain stopped. Brain is control center of body so overall function of body deteriorated.
• Identify the risk factors of stroke such as hypertension, smoking, high cholesterol, diabetes, heart disease, lack of physical activities.
• Adopt healthy lifestyle to reduce progression of disease
• Advice to prevent the risk of falling.
• Test the temperature with hand or foot that was not affected by stroke.
• Take medication on time
• Begins exercise program.
• Speech therapy
• Cessation of smoking and alcohol
• Reduce amount of fat and cholesterol
• Eat more fruits and vegetables
• Limit vegetable oil and nut oil
• Using low fat diary products
• Close follow up.

Nursing diagnosis and intervention

1. Ineffective cerebral tissue perfusion related to inadequate blood supply to brain
2. Impaired physical mobility related to hemiparesis
3. Impaired verbal communication related to impaired cerebral circulation : neuromuscular impairment.

Nursing intervention

• Assess the factor related to individual situation for decreased cerebral tissue perfusion and potential for increased ICP.
• Evaluate neurological assessment
• Monitor vital signs
• Documents change in vision
• Assess higher function including speech
• Assess the sign and symptoms of increased ICP
• Assess the activity levels
• Assist the activity of daily living
• Assist the rehabilitation service
• Assess the extent of dysfunction
• Ask to follow simple command point to object and ask to name them
• Have patient produce simple sentence
• Provide speech therapy

MEDICATION

• Recombinant tissue plasminogen activator
• Osmotic diuretics to prevent increased ICP
• Antihypertensive to control blood pressure