NUR 2755 Multidimensional Care IV - MDC 4 Exam 1

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How to care for a patient with homonymous hemianopia after a stroke?

- Turn head side to side to expand visual field

Scanning technique is useful when eating or ambulating

How to Care for a patient with Left side stroke and right sided deficit

- Reorient as needed

- Establish a structured routine

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- Encourage patient to do ADL as independently as possible

- Give patient simple easy to follow instructions

What do Left side stroke patients with right side deficits experience?

- Aphasia (Inability to speak)

- Alexia (Difficulty reading)

- Agraphia (Difficulty writing)

- Acalculia (Difficulty with math)

How to manage a patient with proprioception (position sense)?

- Teach the patient to touch and use both sides of the body.

When dressing, remind the patient to dress the affected side first. 

What do Right side stroke patients with Left side deficits experience?

- Impaired sense of Humor

- Disorientation of time, place and person

- Loss of depth perception

- Impulsiveness

- Loss of ability t hear tonal variations

- Left side hemiplegia or hemiparesis

Patient education for Parkinson’s

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- Report dizziness

- Delirium

- Maintain quality of life

- Help alleviate or manage symptoms

- Take medication at the same time

Assessment findings for Parkinson’s

- Tremors

- Muscle rigidity

- Bradykinesia

- Postural instability

Medication for Parkinson’s

- Carbidopa/ Levodopa

Give at set time do not change

Assessing GBS

- Hallmark finding: Ascending paralysis which can cause acute respiratory

failure 

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Patient interventions for GBS

- Monitor vitals and ECG

- Help feed patient if needed

- Maintain hydration

- Passive ROM

- Q2 turns

What is a patient with GBS at risk for?

- Respiratory compromise

- Swallowing disorders

Assessment finding for Bell’s Palsy

- Facial drooping unilateral

- Loss of cornea reflex on one side

- Loss of taste on one side

- Excess tearing on one side

- Excess drooling

- Can’t sip or chew on one side

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Patient education for Bell’s Palsy

- Tape eye closed or wear a patch QHS, protective glasses while awake

- Manually close eyelid often

- High-calorie snacks, soft diet

- Warm, moist compresses and massage to the affected area

- Don't chew on face

What is Generalized

- Reversible LOC, inhibits neuronal impulses 

When is generalized anesthesia appropriate?

- Major surgeries such as

Open heart

Brain surgery

When is local anesthesia appropriate?

- Used in patients that just need a quick procedure while still conscious such

as

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Skin Biopsy

Breast Biopsy

Stitching a deep cut

Use of regional anesthesia

- Numbs a much larger area but still keeps the patient conscious such as

Epidurals

What is Local Anesthesia

- Delivered topically and by local infiltration

- Moderate sedation

- Twilight sleep

- Conscious sedation

Where is regional anesthesia injected?

- Injected around major nerves to block sensation and pain to a specific area

of the body.

Who gives and signs inform consent?

- Doctor

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