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HEMORRHAGIC STROKECommon Nursing diagnosis found in nursing care plans for stroke is; Impaired verbal communication, Impaired physical Mobility, Anxiety [specify level], Deficient knowledge regarding diagnosis  prognosis and treatment options, Risk for disturbed Body Image, Risk for ineffective Sexual Pattern, Self-Care Deficit [specify], Disturbed Sensory Perception (specify), Disturbed Thought Processes, Risk for Injury/Trauma

Below is sample of Nursing Outcome, Nursing interventions and evaluation nursing care plans for Stroke

Nursing Diagnose

Nursing Outcomes

Nursing Interventions

Evaluation

Impaired verbal communication
  • Verbalize or indicate an understanding of the communication difficulty and plans for ways of handling.
  • Establish method of communication in which needs can be expressed.
  • Participate in therapeutic communication (e.g., using silence, acceptance, restating reflecting, Active-listening).
  • Demonstrate congruent verbal and nonverbal communication.
  • Use resources appropriately.
  • Review history for neurological conditions that could affect speech, such as CVA, tumor, multiple sclerosis, hearing loss.
  • Note results of neurological testing such as electroencephalogram (EEG), computed tomography (CT) scan.
  • Note whether aphasia is motor (expressive: loss of images for articulated speech), sensory (receptive: unable to understand words and does not recognize the defect), conduction (slow comprehension, uses words inappropriately but knows the error), and/or global (total loss of ability to comprehend and speak). Evaluate the degree of impairment.
  • Evaluate mental status, note presence of psychotic conditions (e.g., manic-depressive, schizoid/affective behavior). Assess psychological response to communication impairment, willingness to find alternate  of communication.
  • Note presence of ET tube/tracheotomy or other physical blocks to speech (e.g., cleft palate, jaws wired). Determine ability to read/write. Evaluate musculoskeletal states, including manual dexterity (e.g., ability to hold a pen and write).
  • Obtain a translator/written translation or picture chart when writing is not possible.
  • Facilitate hearing and vision examinations/obtaining necessary aids when needed/desired for improving communication. Assist client to learn to use and adjust to aids.
  • Establish relationship with the client, listening carefully and attending to client’s verbal/nonverbal expressions.
  • Keep communication simple, using all modes for accessing information: visual, auditory, and kinesthetic
  • Determine meaning of words used by the client and congruency of communication and nonverbal messages.
  • Validate meaning of nonverbal communication; do not make assumptions, because they may be wrong. Be honest; if you do not understand, seek assistance from others.
  • Individualize techniques using breathing for relaxation of the vocal cords, rote tasks (such as counting), and singing or melodic intonation to assist aphasic clients in relearning speech.
  • Anticipate needs until effective communication is reestablished.
  • Plan for alternative methods of communication (e.g., slate board, letter/picture board, hand/eye signals, typewriter/computer) incorporating information about type of disability present.
  • Provide environmental stimuli as needed to maintain contact with reality; or reduce stimuli to lessen anxiety that may worsen problem.
  • Use confrontation skills, when appropriate, within an established nurse-client relationship to clarify discrepancies between verbal and nonverbal cues.
  • Involve family/SO(s) in plan of care as much as possible. Enhances participation and commitment to plan.
  • Response to interventions/teaching and actions performed.
  • Response to interventions/teaching and actions performed.
  • Attainment / progress toward desired outcome(s).
  • Modifications to plan of care.

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5 Comments

  1. Ruth says:

    Thanks for the information about stroke. The article helps me a lot during our reporting..

  2. Akata Parker says:

    this has definately given me an idea on how to manage stroke….thnks alot

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