In school, we were always taught to approach a stroke pt from the unaffected side...
And now while studying I see that when a patient has unilateral neglect (dont all stroke pt have unilateral neglect?) from a stroke, you approach them from the affected side, placing commode, personal items all on the affected side...
Im sure Im missing something, can someone help??? This is really bothering me...lol.
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]
[color=#993399] copy of an outline drawing by a left neglect patient.
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.
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
Iam VERY new to nursing, but in class we were always told to approach from the unaffected side, so as not to startle the pt., but to place items on affected side so as to encourage use. Dont know if this will help any, but best of luck on th NCLEX!!!:)
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]
[color=#993399] copy of an outline drawing by a left neglect patient.
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.
thank you !
however that does not explain why we are taught to approach from the unaffected side, and the reference books say both...
im sorry to be a pia, but im afraid im going to see this on the nclex.
Is your book talking about someone with a CVA, or someone with a CVA and unilateral neglect syndrome. There is a difference as mentioned in ealier posts. If it's a straightforward CVA, approach from the unaffected side, if it's a CVA with unilateral neglect syndrome you approache from the affected side. Someone with UL negelect has no awareness that side is there, someone with a straight CVA knows it's there and can't use it.
Is your book talking about someone with a CVA, or someone with a CVA and unilateral neglect syndrome. There is a difference as mentioned in ealier posts. If it's a straightforward CVA, approach from the unaffected side, if it's a CVA with unilateral neglect syndrome you approache from the affected side. Someone with UL negelect has no awareness that side is there, someone with a straight CVA knows it's there and can't use it.
Sorry for typos---it's wee hours of the am for me.... :)
rn/writer, RN
9 Articles; 4,168 Posts
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]
[color=#993399] copy of an outline drawing by a left neglect patient.
[color=#993399]http://www.undergrad.ahs.uwaterloo.ca/~aktse/unilateral.html
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.