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Nurse_Nat_1984

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  • Joined: Mar 2008
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  • Posts: 4

Mon Mar 17, 2008 2:03 pm

Hi i got my first assignment and i was wondering if i could get other peoples views on the below question i have received, i am really greatfully if someone can help out.

You are a Div 2 nurse, working in a rehabilitation hospital. you are required to care for a 75 year man who is being rehabilitated following a STROKE. As a result of the stroke, the client is able to ambulate with a stick, he has not suffered any cognitive damage, but the stroke has left him aphasic, dysgraphic and with very poor vision.

discuss
- The communication issuses you may encounter as a div 2 nurse caring for this client
- Define the strategies you would employ in communication and providing care for this client
- Discuss the different mode of communication

Celle

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  • Joined: Jan 2008
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Mar 21, 2008, 06:47 pm

Hi Nurse Nat,

In response to your question, rather than just give you my views I thought perhaps I might get you thinking abut the issues at hand......

How would you communicate with someone who has had a stroke?? Remember that (a) they arent deaf, (b), they aren't idiots, (yes I have seen/heard some nurses speak to patients as tho they are idiots!)

Would you speak fast, slow, clearly, mumble?

Would you look directly at them or look somewhere else???

What modes of communication are available? Sign, whiteboards, pictureboards etc.

Anyway, just a start for you to the ball rolling!

Cheers

Celle

Nurse_Nat_1984

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Mar 25, 2008, 04:43 pm

Thanks for your reply.
The one thing im having trouble with is Aphasia, as ive looked it up and they say they cant understand what other people are saying, so if you gave them a whiteboard could they write what they want if they cant understand anymore? and with dysgraphic they may lake co-ordination so they might not be able to write on a whiteboard. im just having trouble trying to do "Define the strategies you would employ in communication and providing care for this client"? i can say eye contact would be important, pointing to the object that you are trying to explain to the patient. i just keep researching and researching. i want to do this right and be able to find out everything i can about this symptoms.
Natalie

Celle

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Mar 26, 2008, 11:39 am

Aphasia is a deficit in the ability to communicate, and may involve any or all aspects of communication. My understanding of aphasia is that several different types exist....of which is not obviously specified in the assignment! Perhaps the best way to communicate is to teach yes and no, with some type of movement, head nodding, eye blinking!

Food for thought!

Ronnie

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Ronnie
  • Joined: Oct 2006
  • Location: XXXXville
  • Posts: 34

Mar 27, 2008, 11:39 pm

Nat, from your reply it looks to me as though you are employing the main strategy which is critical thinking. You have identified what difficulties would possibly be experienced by this patient. If you eliminate the things you think won't work then you can move onto other areas that may work.

Maybe prompting the patient to perform a task might be useful. If the patient is lying supine for example, initiating the movements of sitting up my provide the necessary response by the patient. Guiding the patient to their feet and assisting them to the bathroom then positioning them over the toilet prompts them in this area also.

When doing this you are able to assess the patients level of motor functioning, ability to ambulate and mobilise, facial expression for pain etc.

I know from working with some dementia patients in the past when it was time for their medication, the tablet was placed in their hand and the hand was guided toward the mouth. This initiated a response that allowed them to place the tablet in their mouth. The glass of water was promted toward their mouth and they would follow through and take a sip.

We develop learned behaviour and although cognitive ability can be altered, sometimes things that have been done thousands of times throughout the course of life become like a reflex action. I'm not saying this works for all patients but I've seen it work for many.

Cheers

keeshy

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keeshy
  • Joined: Apr 2007
  • Location: Melbourne
  • Posts: 189

Apr 03, 2008, 10:45 am

Ummm where are you studying??? I was given EXACTLY the same assignment!!

I got a distinction for it (marked by our toughest marking teacher) I wont add anything extra to confuse you becuase what the others have said is pretty good. You need to think about all the aspects of his condition and use critical thinking to overcome the obstacles that his conditions represent.

Good luck and if you need any other help you can add me to msn akeesha444@hotmail.com . I am sure you will great with the assignment!!

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