Question

Patient Profile

M.K. is a 74-year-old woman who is being transferred to the rehabilitation unit 2 weeks post thrombotic stroke. M.K. is accompanied by her daughter, who expresses frustration that her mother “just will not eat.” M.K. is currently on a soft, pureed diet.

Subjective Data

• Daughter states she is very worried about her mother’s decreased appetite and food intake since the stroke.
• Daughter states her mother has been losing weight since the stroke.

Objective Data

• Height 5’4”,weight 114 lb
• Alert and oriented x 3 spheres
• Can follow directions but has difficulty expressing herself
• Coughs and chokes periodically when eating or drinking
• Skin and mucosa are dry, with tenting
• Has right-sided hemiplegia
• Appears pale, weak, tired

1. What are the priority nursing diagnoses for M. K.?
2. What are the priority nursing goals for M.K.?
3. As M.K.’s case manager, you will be coordinating efforts with speech, occupational, and physical therapists, as well as the dietitian. What is the role that each of those professionals will play in M.K.’s care?
4. What nursing interventions could be part of M.K.’s plan of care?
5. What dietary options are available for M.K.?

Answer 1

The priority nursing diagnosis are,

• Risk for impared swallowing related to disease condition
• Impared physical mobility
• Ineffective cerebral tissue perfusion
• Impared verbal communication
• Activity intolarance
• Ineffective coping

The nursing goals are,

Patient will display no further deteriration/recurrence of deficits

Patient will demonstrate feeding method apriopriate to individual situation and aspiration prevention

patient maintain desired body weight

manage dehydration

Patient will perform self care activites within level of own ability

patient will verbalise awareness of own coping abilities

patient maintain usual level of conciousness

The role of therapists in the care of Mr MK

Speech therapist - play a significant role in screening ,assessing and management and rehabilitations of stroke survivors they are having dysphagia and communication difficulties

Physical therapists-they are able to stimulate affected muscles and nerves to maintain circulation and prevent stiffness.they guide and helps to do the active and passive exercises for the stroke recovery.

Dietitian- They provide education session for all MDTs , they assess the providenutritional management of the patient, and helps in oral nutrition,enteral feeding and ethics of feeding.

The nursing interventions are,

• Maintain intake and out put chart
• Assess the patients condition and ability to swallow
• Promote effective swallowing
• Assist patient with head control and positon based on specific dysfunction
• place food of appropriate consistency in unaffected side of mouth
• Feed slowly allowing 30-45 min for meals
• Maintain up right position
• Adminnister IV or Tube feeding
• Identify previous bowel habits and reestablish normal regimen
• Avoid doing things that patient can do

The diatary options available for MK are,

We can feed the patient by his ability for take feed by orally,IV ortube feeding.

Choose low fat ot fat free foods, calcium rich food,high calory and vitamin rich foods,include beans,peas,nuts,seeds,poultry and fruits.

plz give a thums up