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Stroke (Effect on concepts (Nutrition (After stroke--> patient will…

- - - - Start passive ROM the day after the stroke
      - Start active ROM ASAP
  - - - Immobility
      - Decreased perfusion
      - Decreased sensation
  - - - Bowel training--> take them to the bathroom at the same time every day
      - Bladder training--> give adequate hydration and take to the bathroom ever 2 hours
  - - - Give oral care every 2 hours--> prevent ventilator assisted pneumonia
      - Might need an oropharyngeal airway to keep the tongue from collapsing on the airway
- - - - Past health history--> past strokes,
        hypertension, smoking, DM, aneurysm
      - Family history
      - Medications: anticoagulants,
        antihypertensive meds, illicit drugs
      - TIME OF ONSET
    - - General appearance, LOC, fear
      - Respiratory: labored breathing, tachypnea, airway occlusion
      - Cardiovascular: hypertension, tachycardia, carotid bruit
      - GI: constipation, gag reflex
      - GU: incontinence
      - Neuron: Altered LOC, pupils, aphasia, visual effects, NHI stroke scale
- - - - Age
      - Gender
      - Ethnicity
      - Family history
    - - hypertension
      - Heart disease
      - Smoking
      - Diabetes
      - Obesity
      - Lack of physical exercise
      - Poor diet
      - illicit drug use
  - - - Paralyzed left side
      - Left sided neglect
      - Spatial-perceptual deficits
      - Tends to deny or minimize problems
      - Rapid performance--> short attention span
      - Impulsive, safety problems
      - Impaired judgement
      - Impaired time concepts
    - - Paralyzed left side
      - Impaired speech, aphasia
      - Aware of deficits, depression and anxiety
      - Imported right/left discrimination
      - Slow performance, cautious
      - Impaired comprehension of language and math
    - - Balance
      - Eyes
      - Face
      - Arms
      - Speech
      - Time