Knowledge deficit related to Cerebrovascular Accident

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Goal: Patient and caregiver will describe Cerebrovascular Accident, recognize the warning signs of a stroke, and know risk factors and measures to prevent a recurrence

Interventions

  1. Instruct patient/caregiver that CVA (Stroke) is a loss of brain function resulting from a disruption in blood flow to part of the brain, caused by thrombosis, embolism, or hemorrhage
  2. Teach patient/caregiver that the warning signs of CVA (Stroke) are a sudden temporary weakness or numbness to one side of the body; temporary loss of speech, or slurred speech; unexplained dizziness, unsteadiness, or falls; temporary loss of vision or blurred vision; and change in LOC
  3. Instruct patient/caregiver that the factors that increase risk of CVA (Stroke) are advancing age; positive family history; race (blacks have higher incidence than whites); sex (men have higher incidence than women); prior stroke; history of diabetes, cardiac & renal disease Continue reading →

Knowledge deficit related to Alzheimer’s Disease

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Goal: Patient and caregiver will describe Alzheimer’s Disease, can recognize s/s, and management of disease process.

Interventions

  1. Instruct patient/caregiver that Alzheimer’s Disease is a type of dementia causing impairment of intellectual functioning caused by degeneration in nerve endings and brain cells
  2. Instruct patient/caregiver that Alzheimer’s disease involves progressive, irreversible loss of memory with symptoms including forgetfullness, unpredictable moods, short attention span, difficulty with verbal communication, loss of concentration or total inability to care for self
  3. Instruct patient/caregiver on measures to decrease confusion including; approach patient in a calm, slow manner, explain things slowly, in simple language what needs to be done, and maintain a familiar routine and environment Continue reading →

Caregiver role strain

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Goal: Prevention of caregiver role strain, as evidenced by continued safe and appropriate care provided without compromise to caregiver’s own physical and emotional needs

Interventions

  1. Assess and evaluate patient/caregiver relationship and pattern of communication
  2. Assess and evaluate family resources and support systems
  3. Assess and evaluate for neglect and abuse, and take necessary steps to prevent injury to pt and strain on caregiver
  4. Assess and evaluate caregiver health Continue reading →

Alteration in family ability to cope : compromised

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Goal: Optimal level of participation and support by family members to facilitate changes in pt’s life-style and improvment in health status

Interventions

  1. Assess and evaluate level of family anxiety
  2. Assess and evaluate family perceptions of problem, and evaluate strengths, coping skills, and current support systems to utilize previously successful techniques
  3. Assess and evaluate role of patient in family structure
  4. Encourage questions or expressions of concern and provide honest, appropriate answers to family questions Continue reading →

Impaired social interaction

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Goal: Optimal social relationships, as evidenced by participation in social activities with significant others and support groups, and absence of hostility in voice and behavior

Interventions

  1. Assess and evaluate affect
  2. Assess and evaluate eye contact
  3. Assess and evaluate spontaneity and verbal frequency
  4. Assess and evaluate involvement with others
  5. Encourage relationship with patient by spending time with him/her, providing supportive contact Continue reading →

Helplessness

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Goal: Decreased hopelessness, as evidenced by increased involvement in care and activities

Interventions

  1. Assess and evaluate for isolation (physical, emotional, spiritual), chronic stress, and poor physical health
  2. Assess and evaluate for defense mechanisms used including denial, isolation, regression
  3. Assess and evaluate for nonverbal and verbal indicators of hopelessness: poor eye contact, slumped posture, flat affect, monotone speech, retarded speech
  4. Discuss how life used to be and activities performed when patient was happy Continue reading →

Fear

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Goal: Patient will identify source of fear, implement a positive coping mechanism, and verbalize reduction/absence of fear

Interventions

  1. Assess and evaluate what patient is fearful of by careful/thoughtful questioning and document behavioral and verbal expressions of fear
  2. Acknowledge awareness of patient’s fear and maintain a calm and tolerant manner while interacting with patient
  3. Instruct patient/caregiver re: reducing sensory stimulation by maintaining a quiet environment and encouraging rest periods to improve ability to cope Continue reading →

Disturbance in self – esteem

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Goal: Patient will begin to recognize, accept, and verbalize positive aspect of self and self capabilities

Interventions

  1. Assess and evaluate past and current level of functioning; emotional, social, intellectual, vocational, and physical
  2. Assess and evaluate quality/quantity of verbalizations regarding self
  3. Assess and evaluate for evidence of change in behavior
  4. Assess and evaluate degree to which pt feels in control of own behavior and feels loved and respected by others
  5. Assess and evaluate patient level of competence re: ability to perform and/or carry out own/others expectations Continue reading →

Anxiety

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Goal: Patient will recognize signs of anxiety at low-intensity level and demonstrate a positive coping method

Interventions

  1. Acknowledge awareness of patient’s anxiety. Do not try to reassure patient that “everything will be alright”
  2. Maintain a calm and tolerant manner while interacting with patient and assure pt that he/she is safe
  3. Encourage patient to talk about anxious feelings and examine the anxiety-provoking situation
  4. Assist in developing anxiety-reducing skills such as relaxation, deep breathing, and positive visualization Continue reading →

Alteration in thought processes

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Goal: Patient will experience reduced disorientation to time, place, person, and situation and will interact with others appropriately

Interventions

  1. Assess and evaluate degree of orientation to time, place, person, and situation
  2. Orient patient to surroundings and reality as needed: use patient name when speaking to him/her; speak slowly and clearly; refer to the time of day, date, and recent events when interacting with pt; encourage pt to check calendar and clock frequently; be matter-of-fact and respectful when correcting pt’s misperceptions of reality Continue reading →