Diagnosing the Problems in Stroke

Abstract

On a cold winter day, Ms. W, a 47year-old wife and mother of two teenagers, was brought to the hospitaJ from work. She had suddenly developed right-sided weakness and difficulty speaking. The medical diagnosis was left middle cerebral artery cerebrovascular accident secondary to thrombosis. Her history revealed that she had been treated for hypertension for several years. On physical examination, she exhibited flaccid rightsided hemiplegia, right facial paralysis, and speech limited to yes1 and responses. She had no peripheral vision on the right and no awareness of the position of her right arm and leg. Her family appeared supportive and willing to learn how to help Ms. W recover and return home. Ms. W's immediate post-insult care was directed toward maintaining life functions. Once Ms. W had stabilized, a complete nursing assessment was performed. The following are some of the nursing diagnoses that were identified: * impairment in communication related to aphasia * sensory-perceptual alteration related to right-sided hemianopsia and hemiparesthesia * impaired physical mobility related to hemiplegia and hemiparesthesia on right * alteration in nutrition related to impaired swallowing and rightsided hemiplegia * alteration in pattern of urinary elimination related to impaired impulse to void associated with neurogenic bladder * alteration in bowel elimination related to alteration in nutrition, immobility, and impaired defecation impulse * potential impairment in skin integrity related to diminished sensation, impaired mobility, and incontinence.