Nursing Care and Rationale - Essay Example

Many patients with ischemia stroke dont like going through the treatment plan, yet, this means the real possibility of losing their lives”. Introduction Stroke is the second leading single killer disease in Australia after heart disease and number one cause of disability. National Stroke Foundation projects that, in 2011, 60,000 cases of stroke will be reported and about 6% of this number will die, while about 70% suffer permanent or recurrent disability. About 20% of all strokes happen in those below 55years old. Australian government spends nearly $2.14 billion annually on treatment of stoke.. Globally, china has the highest cases of stoke with nearly 1.5 million Chinese dying from stroke each year. There are two main types of stoke, these are ischemia and hemorrhagic. Ischemia has four different stokes. In ischemia, blood fails to reach some parts of the brain. In hemorrhagic, bleeding or hemorrhage occurs into the brain or in the fluid near the brain. As explained by Dawes, et at. (2007, 54) in brain ischemia, the flow of blood to some part of the brain stops, thus denying cells in this area adequate oxygen and energy they require. This results in the failure of neurons, which dies when blood flow is not restored soon enough. The brain damage resulting from the deprivation of blood to brain is referred to as ischemic stoke, while the area damaged is known as a brain infarct. Brain ischemia normally develops suddenly, and in many cases it occurs in the morning. Ischemia symptoms varies depending on the part of the brain that affected by not receiving blood. At times, an individual will suffer from vision loss either in both eyes or in one eye. A person could as well feel weakness or reduced senses in the leg, hard, arm and face on one side or on both sides, or the person could have difficulties in walking. Other symptoms include dementia, amnesias, and difficulties in speaking, reading or writing. These symptoms can as well differ in severity and duration. This paper is a case study of patient, Mrs. Hives, aged 69, who has been admitted due ischemic stoke. The paper will provide an overview of pathophysiology and nursing care and rationale of Ischemic in relation to the patient. Nursing Care and Rationale Mrs. Hive, who has an ischemic stroke, will have to undergo through three types of therapy that aim at restoring her normal heath conditions. The first one is physical therapy that has a great concern on regaining gross motor deficits (Rogers 1992, 37). The second one is called occupational therapy that deals with fining motor functions and deficits that exist in focal, brain functions that include calculations and daily duties such dressing, bathing as well as kitchen activities. Lastly, speech therapy bases its target on recovery and assessment of two vital functions such as speech functions as well as swallowing ability of the patient (Wester, et al 1999, 46). For treatment of Mrs. Hive, nurses should use Roper, Logan and Tierney model, developed for living activities that they developed to in the process of rehabilitation. This model is most appropriate for Mrs. Hive because it focuses at her holistically and this is important in rehabilitation process as a victim of stroke can be suffering from other numerous different problems apart from visible ones (Wester, et al 1999, 46). To start with, the nursing model of Roper, Logan and Tierney is based on the hierarchy of human needs that a psychologist called Abraham Maslow identified. This model arranges human needs from the most basic to those ones that more sophisticated. In this theory, for people to express themselves in intellectual and creative endeavors, then nurses must put into consideration basic safety and psychological needs like need for water, food and air that Mrs. will need for stay in the hospital (Roper, et al. 199l, 231). When Mrs. Hive settles in the hospital, senior nurses will have to sit down with her and start the nursing cardex admission pack to critical asses her situation and hence come up with a proper medication process. The trust team sets out this standardized package to adhere to all standards of clinical governance. This pack consists of all the relevant documentation to assess the patient and come up with a standardized package of care. This pack bases its operation on Roper, Logan and Tierney activity of daily living that at the same time is individual to every patient that suffers from ischemic stroke (Alexander, et al. 2000, 177). The information that the pack provides when compiled with the current situation of Mrs. Hive is vital in aiding in the development of her care plan. Since Mrs. Hives was suffering from mild dysphasia, those in charge were required to use a lot of communication skills in order to understand what she was saying as well as communicating information to her in such as a way that do not require complex long answers (Rogers 1992, 213). Wester, et al (1999, 47), cites that nurses carry out the assessment process of a patient in most cases in a poor way due to making of unnecessary assumptions about situations stroke patients. Those in charge of assessment process of a patient in most cases chunk together admission with assessment and this indicates that most hospitals talk about admitting instead of assessing a new patient. Psychological and physical problems are key causes of continence in patients who suffer from ischemic stroke. When these factors are present with poor mobility incontinence, then it easily leads to skin problems such as broken spots that lead to pressure sores on the body of a patient. This in turn gets the patient by continued soiling. The nurse has a duty of keeping continuous observations of Mrs. Hive to hinder significant discomfort on her body (Rogers 1992, 213). To use catheter in initial stages is of great importance during initial stages of rehabilitation on admission of Mrs. Hive. This type of stroke may make the patient be unaware of her situation so nurses have to keep a watch on her effectively monitor changes that she goes through. Further, nurses may be forced to have her placed on a fluid balance chart to record abnormalities that exist in her urinary output and a stool chart to try to establish a pattern to aid is lessening her discomfort. This will assist in improving her situation slowly by slowly to a point where she will be able to control herself and thus request for the removal of the catheter (Roper, Logan and Tierney 199l, 306). The safety of the patient is very important and nurses should not carry out activities that in turn hurt the patient. Since ischemic stroke causes hemiplegia, nurses should take care of paralyzed limbs and avoid hazards of immobility. In addition, a patient suffering from this kind of stroke may loss her conscious level and in order to reduce a number of dangers that such a patient may suffer while undergoing treatment, nurses should be carefully when offering care. She should also get necessary consideration when nurses try to improve her ability to communicate with others orally and using gestures. Mrs. Hive had right sided weakness for safety purposes it is important that when it comes to transferring her, to use the hoist for any mobilization (Wester, et al 1999, 48). Since loss or impairment of speech is a threatening experience for Mrs. Hive, it is vital that nurses carry out an early speech therapist to ensure that an expert assessment is performed and identify a strategy of dealing with the situation. It is important for nurses to identify the nature and type of the speech problem that is if the difficulties of a patient relate to comprehension or expression. The nurses therefore, should encourage any patient to perform prescribed exercises that a therapist develops. If Mrs. Hives will not be able to communicate verbally to express her feelings, at times, she may feel trapped inside a body and therefore nurses may carry out some actions that she may not like. The therapist need to remind her about what has taken place to her and the way she feels how events should be taking place to reassure her (Roper, Logan and Tierney 199l, 240). Advantages of Roper, Logan and Tierney model This model leads to consistency in the way patients get medical care and this leads to continuity of care patterns and treatments. This implies that the Roper, Logan and Tierney model minimizes conflict within the team of nurses engaged in treating a patient. This model makes it possible for other healthcare involved in treatment of stroke to better understand patient care. This is because the model is self-explanatory and does not have complications as compared to other models of nursing care. It is designed in a simple way to enable learners develop means of thinking about nursing in better terms. According to Roper, et al. (1991, 305), this model ensures that the patient is in a safe environment and is able to communicate well with a nurse attending to her. This is because of its holistic approach, which makes it appealing to patients and possible for nurses to appropriately treat patients after understanding their situations. Disadvantages of Roper, Logan and Tierney model Since the model only focuses on twelve activities while building the theory, it means that it addresses the activities of nursing as deliberative approach to meet twelve components of nursing. Thus, model only concentrates on physical attributes of a body leading to wrong labeling or disregarding of social or psychological aspects of a person. It only concentrates on activities that are ideal to leaving activities of a person. Recommendations about the use of this model in ischemic stroke While treating patients suffering from ischemic stroke it is important to apply Roper, Logan and Tierney model since it addresses all basic needs of living from simple ones to most sophisticated ones. The nurses must avail all these needs for during the patient’s hospital stay. More so, using this model is ideal in ensuring that nurses treat their patients appropriately without hurting them. The care providers should ensure that this model covers all aspects while treating patients with ischemic stroke, and not merely concentrating on physical attributes because this may lead to wrong labeling and wrong outcomes about a patient (Roper, et al. 199l, 306). Conclusion As reported in this paper, each year about 750,000 people suffer from stroke in America, and about 150, 000 people due to brain injuries caused by stroke. As explained by Dawes, et at. (2007, 67) there two types of strokes, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when an artery that carries blood from the heart to the brain is blocked. When the brain does not receive the required supply of oxygen and energy in form of glucose due to this blockage, the brain fails to work effectively and the area affected starts to die. If this continues for some hours, then that brain area not receiving blood may die completely and permanently stop to functioning. Ischemic stroke is more common than hemorrhagic stroke, and it occurs more than five times more than hemorrhagic stroke. As noted by Wester, et al (1999, 48) stroke is different, and the symptoms and impact differ depending on the area of the brain affected as well as the size of damage that has occurred. For some patients, the impact is severe for others it’s mild. Normally the symptoms appear immediately though they may occur when a person is asleep. Usually, when one side of the brain is injured, the opposite side of the body is affected. The Glasgow Coma Scale (GCS) is used to measure the level of stroke, and depending on this level treatment plan is reached. Symptoms of stroke include, sudden numbness, weakness of arm, leg or face (hemiparesis); many patients suffer from these symptoms. Other symptoms include sudden confusion, difficulties in speaking or comprehending, mild dysphasia. There are three types of therapy aimed at restoring normal heath conditions of stroke. This includes physical therapy, occupational therapy and speech therapy. To treat patients like Mrs. Hive, with ischemic stroke, nurses should use Roper, Logan and Tierney model, because it focuses on patients holistically, this is important in rehabilitation of stroke patients. In conclusion, it is important for stroke patients to get medical attention from hospitals. Caregivers must use different nursing models. The care plans that these models bring out continuously are updated by engaging all the relevant professionals to ensure continuity of care. Bibliography Alexander, F, Fawcett, N and Runciman 2000, Nursing Practice, Hospital & Home: The Adult: 2nd Edition: Churchill & Livingstone. Spain American Heart Association (2010): Heart and Stroke Statistical Update. Dallas, Texas: American Heart Association. Dawes, E, Lloyd, H & Durham, L 2007, ‘Monitoring and recording patients’ neurological observations’, Nursing Standard, vol. 22, no. 10, pp. 40-45. Henderson, V. 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