Nursing care for patients who have had a stroke

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  1. care plan for a stoke pt

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      how to write a nursing care plan
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      how to write a nursing care plan

Need help writing a nursing care plan for a patient that have a stroke

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Specializes in Hospital Education Coordinator.

poll does not make sense. Both options are the same

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Specializes in Peds, Med-Surg, Disaster Nsg, Parish Nsg.

Moved to Nursing Student Assistance

Please tell us what you have so far for your care plan. Then we will be better able to help you.

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Need help writing a nursing care plan for a patient that have a stroke
Its a project I am doing about a stroke so it ask for definition, signs& symptoms, medical treatment, patient teaching and nursing care, expected Outcome
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Use a nursing dx book. It has it all:)

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Its a project I am doing about a stroke so it ask for definition, signs& symptoms, medical treatment, patient teaching and nursing care, expected Outcome

We are happy to help but we will not do it for you.What do you have so far? Is this a real patient? What is the assessment if this is a real patient. What is the poll about? What semester are you?

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

From another post of mine........

Welcome to an! the largest online nursing community!

ok...first......you are falling into the same hole that trips most new students. You find your diagnosis and then try to retrofit them into the diagnosis. let the patient/patient assessment. drive your diagnosis. do not try to fit the patient to the diagnosis you found first. you need to know the pathophysiology of your disease process. You need to assess your patient, collect data then find a diagnosis. let the patient data drive the diagnosis.

What is your assessment? What are the vital signs? What is the neuro assessment. Is the the patient having pain? are they having difficulty with adls? what teaching do they need? what does the patient need? what is the most important to them now? what is important for them to know in the future.

The medical diagnosis is the disease itself. It is what the patient has not necessarily what the patient needs. the nursing diagnosis is what are you going to do about it, what are you going to look for, and what do you need to do/look for first.

Care plans when you are in school are teaching you what you need to do to actually look for, what you need to do to intervene and improve for the patient to be well and return to their previous level of life or to make them the best you you can be. it is trying to teach you how to think like a nurse.

Think of the care plan as a recipe to caring for your patient. your plan of how you are going to care for them. how you are going to care for them. what you want to happen as a result of your caring for them. what would you like to see for them in the future, even if that goal is that you don't want them to become worse, maintain the same, or even to have a peaceful pain free death.

From a very wise an contributor daytonite.......make sure you follow these steps first and in order and let the patient drive your diagnosis not try to fit the patient to the diagnosis you found first.

Every single nursing diagnosis has its own set of symptoms, or defining characteristics. they are listed in the nanda taxonomy and in many of the current nursing care plan books that are currently on the market that include nursing diagnosis information. you need to have access to these books when you are working on care plans. there are currently 188 nursing diagnoses that nanda has defined and given related factors and defining characteristics for. what you need to do is get this information to help you in writing care plans so you diagnose your patients correctly.

Don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. these will become their symptoms, or what nanda calls defining characteristics.

Here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan:

  1. assessment (collect data from medical record, do a physical assessment of the patient, assess adls, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
  2. determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
  3. planning (write measurable goals/outcomes and nursing interventions)
  4. implementation (initiate the care plan)
  5. evaluation (determine if goals/outcomes have been met)

care plan reality: the foundation of any care plan is the signs, symptoms or responses that patient is having to what is happening to them. what is happening to them could be a medical disease, a physical condition, a failure to be able to perform adls (activities of daily living), or a failure to be able to interact appropriately or successfully within their environment. therefore, one of your primary aims as a problem solver is to collect as much data as you can get your hands on. the more the better. you have to be a detective and always be on the alert and lookout for clues. at all times. and that is within the spirit of step #1 of this whole nursing process.

Assessment is an important skill. it will take you a long time to become proficient in assessing patients. assessment not only includes doing the traditional head-to-toe exam, but also listening to what patients have to say and questioning them. history can reveal import clues. it takes time and experience to know what questions to ask to elicit good answers. part of this assessment process is knowing the pathophysiology of the medical disease or condition that the patient has. but, there will be times that this won't be known. just keep in mind that you have to be like a nurse detective always snooping around and looking for those clues.

A nursing diagnosis standing by itself means nothing. the meat of this care plan of yours will lie in the abnormal data (symptoms) that you collected during your assessment of this patient. in order for you to pick any nursing diagnoses for a patient you need to know what the patient's symptoms are.

What i would suggest you do is to work the nursing process from step #1. take a look at the information you collected on the patient during your physical assessment and review of their medical record. start making a list of abnormal data which will now become a list of their symptoms. don't forget to include an assessment of their ability to perform adls (because that's what we nurses shine at). the adls are bathing, dressing, transferring from bed or chair, walking, eating, toilet use, and grooming. and, one more thing you should do is to look up information about symptoms that stand out to you. what is the physiology and what are the signs and symptoms (manifestations) you are likely to see in the patient. did you miss any of the signs and symptoms in the patient? if so, now is the time to add them to your list. this is all part of preparing to move onto step #2 of the process which is determining your patient's problem and choosing nursing diagnoses. but, you have to have those signs, symptoms and patient responses to back it all up.

care plan reality: what you are calling a nursing diagnosis (ex: activity intolerance) is actually a shorthand label for the patient problem. the patient problem is more accurately described in the definition of this nursing diagnosis

definition: insufficient physiological or psychological energy to endure or complete required or desired daily activities

(does this sound like your patient's problem?)

defining characteristics (symptoms): abnormal blood pressure response to activity, abnormal heart rate to activity, electrocardiographic changes reflecting arrhythmias, electrocardiographic changes reflecting ischemia, exertional discomfort, exertional dyspnea, verbal report of fatigue, verbal report of weakness

related factors (etiology): bed rest, generalized weakness, imbalance between oxygen supply and demand, immobility, sedentary lifestyle

i've just listed above all the nanda information on the diagnosis of activity intolerance from the taxonomy. only you know this patient and can assess whether this diagnosis fits with your patient's problem since you posted no other information.

one more thing . . . care plan reality: nursing diagnoses, nursing interventions and goals are all based upon the patient's symptoms, or defining characteristics. they are all linked together with each other to form a nice related circle of cause and effect.

you really shouldn't focus too much time on the nursing diagnoses. most of your focus should really be on gathering together the symptoms the patient has because the entire care plan is based upon them. the nursing diagnosis is only one small part of the care plan and to focus so much time and energy on it takes away from the remainder of the work that needs to be done on the care plan.

a dear an contributor daytonite always had the best advice.......check out this link.

[COLOR=#003366]https://allnurses.com/nursing-student...is-290260.html

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thanks alot for the help, and it isnt a real patient, i have so far diagnosis- stroke( signs and symtoms)

plans and goals

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

A care plan on CVA.....What semester are you? Is this your first care plan?

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this is my first care plan and this is my first semester

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

https://allnurses.com/nursing-student-assistance/help-care-plan-456619.html

The first thing I do when I am helping anyone with their care plans is to go through the nursing process (which is what you should have been doing also). It helps organize you.

Step #1, the assessment w there is no assessment as there is no patient. Grrrrrrrr I hate it when instructors do this becasue the are plan is ALL about the patients care. This makes it difficult for youto see what the are plan really is all about.

Step #2 of the process is to make a list of all the abnormal data. These are the symptoms (nanda calls them defining characteristics) that the patient has. These are important because they form the entire foundation of your resulting care plan. They are the basis for any nursing diagnoses you choose, the goals you decide upon and the nursing interventions you will order. That's pretty much the entire nuts and bolts of the whole care plan, so the symptoms are pretty important and you need to give them their just due.

Other information that is important to know is the patient's medical diagnoses. you need to know the pathophysiology of these conditions because it is through knowing the pathophysiology of the underlying medical conditions that you determine much of the r/t parts of your nursing diagnoses. One of the things you should be doing before even approaching the writing of this care plan is looking up all the information you can find about these five conditions: their signs and symptoms, how the doctors diagnose them, and what the doctors generally order to treat the signs and symptoms of them as well as their underlying cause. that is going to answer some if not all of the questions you posed in your post. you can download and print out the critical thinking flow sheet for nursing students which is a form attached to the end of every one of my posts to help you organize this information for each medical diagnosis. This learning of information about medical diagnoses is crucial to your critical thinking and problem solving of patients problems.

The next part of step #2 is to take the list of your patient's symptoms and shop for nursing diagnoses. a diagnosis is the resulting decision or opinion you make after going through the process of examination or investigation of the facts. You did your examination and investigation of the facts in step #1 (assessment). when a doctor diagnoses someone with a medical condition, they do exactly the same thing. they do a review of systems (medical history) and physical examination of the patient and consider all the abnormal data before putting a medical diagnosis on them. We nurses need to be as careful about doing this as well. we have the nanda taxonomy (a big word meaning a classification--an arrangement or ordering of the nursing diagnoses into some kind of logical grouping) to help us out.

So, you really need some kind of nursing diagnosis book as a reference to help you out here. I, personally, Ackley: Nursing Diagnosis Handbook, 9th Edition and Gulanick: Nursing Care Plans, 7th Edition. They have an online care paln constructor that is pretty helpful. As a student and new learner of how to diagnose, you really need to pay attention to the defining characteristics/taxotomy nad make sure it fitts the patient. NOT to fit the patient to the diagnosis. Before you assign any nursing diagnosis and related factors to a patient you need to verify that it is meeting the nanda criteria for that particular diagnosis. If it isn't, then you've diagnosed it incorrectly and need to keep looking for another more appropriate nursing diagnosis.

The way nanda skirts around this issue of intruding into doctor's territory is to look at the patient's reaction to his medical condition. This is an important concept that is prevalent throughout nursing diagnosing. We don't diagnose medical conditions, but the patient's reaction to them. That means you are assessing their symptoms. So, what are the patient's reaction to, or symptoms of, their diagnosis? This is where your foray into some online resources and filling out a critical thinking flow sheet for nursing students comes in very handy. critical thinking flow sheet for nursing students and student clinical report sheet for one patient.

Now, assuming that you are probably new at assessment, I would compare that list I just posted with what you remember observing in your patient and think about if you might have noticed any of these things and just didn't write them down. if so, add them to your patient's list of symptoms now. you won't have a nursing diagnosis of infection, but you will use your patient's symptoms to diagnose them with other problems that are related to the symptoms of this infection. When you have a real patient.

Lastly, diagnosis prioritization. prioritization is done by the patient's most important needs. Keep in mind that the care plan is a problem solving process, so each nursing diagnosis is actually a patient problem. you list the problems in the order of which is most important of needing attention first. most instructors suggest prioritizing by maslow's hierarchy of needs. the hierarchy from most important to least important is as follows:

  1. physiological needs (in the following order)
    • the need for oxygen and to breathe
    • the need for food and water
    • the need to eliminate and dispose of bodily wastes
    • the need to control body temperature
    • the need to move
    • the need for rest
    • the need for comfort

[*]safety and security needs (in the following order)

  • safety from physiological threat
  • safety from psychological threat
  • protection
  • continuity
  • stability
  • lack of danger

[*]love and belonging needs

  • affiliation
  • affection
  • intimacy
  • support
  • reassurance

[*]self-esteem needs

  • sense of self-worth
  • self-respect
  • independence
  • dignity
  • privacy
  • self-reliance

[*]self-actualization

  • recognition and realization of potential
  • growth
  • health
  • autonomy

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[TD=bgcolor: transparent]This is what i have so far

NURSING CARE PLAN

Assessment: My patient has a history of hypertension and smoking (respiration is a potential problem) at his age, He has a weakness of swallowing, his skin felt cold, loss of sensation. He is feeling of helplessness, loss of hope, loss of appetite, weakness, tingling / numbness to his left side, side also looks like its paralyzed or dead

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[TD=bgcolor: transparent]Abnormal blood pressure

Lack of self-care because of physical weakness

Never damage due to smoking

Inability to flex or extend foot, toes, knee and hand

Imbalanced nutririon

Abnormal Hypothermia

Explain to the patient and the patients family the purpose of movement exercise

Exercise therapy ( assess the ability of patients to the movements, encourage active ROM, change position every 2hrsMonitor the independence of patients

Monitor heart sounds, monitor respiratory status

Building physical needs

Helping my patient feel safe and secure

Making my patient feel love and cared for

Building his self- esstem and self actualization

Monitor medication ( to see if it is working and if they have side effects)

Implementations

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