John Green, a 71-year-old patient, is being discharged from the rehabilitation unit 8 weeks after an

ischemic stroke. The patient’s spouse stated that they used to enjoy going to golf outings with their

friends, but the patient has not played golf since he had the stroke, and she does not want to try to golf

once her husband is discharged home because he has to use a walker and can barely ambulate. She also

states that her husband still has trouble speaking, and his short-term memory is not very astute so it would

be embarrassing to be on a golf outing with him. The patient’s spouse has worn the same outfit to the

rehabilitation unit the past 3 days, and the nurse notices the patient’s hair is unkempt and his affect is flat.

The rehab nurse has made arrangements with the social worker for a physical therapist, speech

therapist, and occupational therapist to provide three sessions of therapy at the patient’s home for the

next 4 weeks, and then a reevaluation will follow to determine if the patient will need further therapy. The

patient is able to sit independently, stand independently, and use a walker. The patient is able to ambulate

30 feet with the walker, and then he requires a short rest before he is able to ambulate another 30 feet.

The patient slurs words occasionally and has hesitant speech. The patient has problems with short-term

speech. (Learning Objective 7)
What educational topics should the nurse provide the family about home care for the patient after stroke?
What assessment of the spouse does the nurse need to make, and what should the nurse suggest?
Three references at the bottom

Sample Solution

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Joan Centers, a 42-year-old patient, presents to the clinic with drooping of the right side of the face with
paralysis of the right eyelid resulting in decreased blinking and inability to close the eye. The patient has
increased lacrimation of the right eye. The patient complains that the right side of her face feels like pins

and needles pricking it, and the pain includes her right eye and behind her right ear. The patient’s speech

is slurred and the patient has no control of facial muscles on the right side when swallowing. (Learning

Objective 4)
How should the nurse describe the diagnosis of Bell’s palsy to the patient?
What medical treatments does the nurse anticipate will be ordered for the patient, and what rationale

justifies the treatments?
What nursing care should be provided for the patient?

Sample Solution

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