Hey hopefully you guys can help me in writing my synthesis paper on stroke. Here is a little background on my guy: he is a 79 year old white male with a diagnosis of acute ischemic stroke. He presented with right hand numbness for 24-36 hours, right facial droop, difficulty swallowing, slow gait, and difficulty with his thought processes. He has a history of diabetes type 2 which is not controlled well and carotid stenosis.
I need to identify nursing diagnoses for the population of stroke patients, which I have the following so far (I have to limit to 10) and then identify which are appropriate for my patient.
Finally I have to prioritize the top 3 nursing diagnoses for my patient and give rationale for my prioritizing....which is what I need the most help on.... Thanks to anyone who has advice
Ineffective cerebral tissue perfusion related to decreased cerebral blood flow; unilateral neglect related to perceptual disruption; impaired verbal communication related to cerebral speech center injury; impaired swallowing related to neuromuscular impairment; risk for aspiration; risk for infection; anxiety; compromised family coping related to critically ill family member; and deficient knowledge
I was thinking my top 3 should be:
1) Impaired swallowing related to weakness of affected muscles as evidenced by drooling and difficulty swallowing secondary to stroke; 2) impaired physical mobility related to generalized weakness and paresis as evidenced by flaccid upper extremity, limited range of motion, decreased muscle strength and decreased physical activity; and 3) risk for aspiration related to dysphagia, impaired swallowing, and depressed gag reflex.
But not sure on the prioritizing and rationale for why!