Stroke Question

In unilateral neglect they quite simply ignore their affected side.So ,under the principle of 'use it or lose it' we try and make them use the affected side by placing things on that side and approaching them from that side so that they have to acknowledge it.

In unilateral neglect they quite simply ignore their affected side.So ,under the principle of 'use it or lose it' we try and make them use the affected side by placing things on that side and approaching them from that side so that they have to acknowledge it.

Ok, I get that...But why then, are we taught to approach stroke pt from the unaffected side...What am I missing?

Dont all/most stroke pt have some type of unilateral neglect?

Not all of them,no.A lot are very positive about their strokes and recovery and do their best to work with the HP's to get back as much function as they can.The quicker the brain is stimulated to find other pathways the better.

Not all of them,no.A lot are very positive about their strokes and recovery and do their best to work with the HP's to get back as much function as they can.The quicker the brain is stimulated to find other pathways the better.

Sort of like collateral circulation? Im reviewing for the NCLEX and in one paragraph, in Saunders under Unilateral Neglect says to approach from the affected side. Next paragraph, says to approach from the unaffected side...I just dont understand - what am I missing??

Im afraid that if i see a question on the subject, I wont know how to answer...?

So are you saying that if there is no unilateral neglect to approach on the unaffected side?

Yes,but of course you have to know if they are neglecting that side? How would you decide that?

sorry to be a pest, but why the contradictions in the stroke pt..Its very difficult to explain what Im trying to say...I get that you approach someone w/ unilateral negelect from the affected side to show them that the side exists...but why then does it also say to approach them from the unaffected side???

Is your book saying to approach stroke patients from the unaffected side or is it saying approach patients with unilateral neglect from the unaffected side?

Think of it this way.If someone is your patient and has not had a stroke do you always approach them from the same side?

Is your book saying to approach stroke patients from the unaffected side or is it saying approach patients with unilateral neglect from the unaffected side?

Think of it this way.If someone is your patient and has not had a stroke do you always approach them from the same side?

The book says both. Approach the stroke pt from the unaffected side, and the pt w/ unilateral neglect from the unaffected side. In school we were also taught to approach from the unaffected side, along w/ commodes and pt belongings, tables ect...

Im just being a pest because Im taking my NCLEX next week & am scared Im going to see a question about this and not know how to answer

Do you have a tutor that you could check out the answer with? This would probably be your best course of action before your exam.

Do you have a tutor that you could check out the answer with? This would probably be your best course of action before your exam.

Nope, just books..maybe i'll look in my med surg book

Thanks

I hope you get a definitive answer before your exam.

unilateral neglect is more than just opting to use the "good" side to the detriment of the "bad side." it is a perception/attention problem originating in the brain that blocks out the fact that the affected side still exists. you have to know something is there to truly make a choice. these folks don't have an awareness of the affected side. for them, it has fallen off the radar.

commonly, stroke patients do battle with diminished sensation and motor capacity. they often need encouragement to work the affected side and retrain their neural pathways to reclaim as much function as possible. but they still "own" the affected side and feel connected to it.

for people with un, the affected side is gone. furthermore, it's as if it was never there. how do you encourage someone to use body parts they don't feel they have?

[color=#993399]one of the most striking disorders of cognition is unilateral neglect. patients with this syndrome act as though whole regions of space contralateral to their lesions do not exist. in early stages, patients may deny ownership of their contalateral limb and also neglect parts of their own body. when dressing, they might not clothe the contralateral side and may fail to groom their hair or shave parts of their faces on that side.

[color=#993399]patients may even fail to eat the food on the left side of their plate or bump into obstacles on their left side. below is a copied picture of a house drawn by a patient with left unilateral neglect.

[color=#993399]

one facet of treatment of un is to call attention to the affected/missing side by stimulating the senses and the limbs on that side. this takes time and dedication, but the theory is that it helps the affected side reawaken by calling constant attention to it in the brain.

this is why you might be advised to approach from the affected side. it's an effort to call that half of the patient to life again. people without un wouldn't need this kind of approach because, although their affected side might not function well, they haven't "lost" it the way someone with un has.

there are many websites that do a more in-depth explanation, but this is the capsule version.