Assessment Subjective: marigatan nak nga mangikuti daytoy imak ken sakak ditoy right side ko Marigatan nak

pay nga agsao kas iti normal naulaw nak idi rabii nakong ngem inturog ko lattan Objective: Head well rounded Presence of white hair Hair evenly distributed (-) alopecia No scars noted on the head Symmetrical face Eyelids aligned Altered vision Snoring while sleeping Dry lips

Diagnosis  Impaired verbal communicatio n related to decrease faci al and oral muscle tone control as evidence by slurred speech.

Analysis  stroke happens when the blood supply to the brain is disturbed in some way. As a result, brain cells are starved of oxygen. In some cases the cerebellum is greatly degrade of oxygenation causing the brain cells in this part to die. The function of this part of the brain includes the center for speech, as an effect the patient experience having a slurred speech

Nursing Objectives  After 8 hrs. of nursing intervention, the patient will demonstrate better communicati on in expressing his needs.

Intervention

Rationale

Evaluation  Goal Meet. After 8 hrs. of nursing intervention, the patient was able to demonstrate a better commu nication in which needs had been expressed.

 Provide  Provide alternative communication methods of needs or desires communication based on individual , like pictures or situation or visual cues, underlying deficit. gestures or
demonstrations

Anticipate and provide for patients needs.

 Helpful in decreasing frustration when dependent on others and unable to communicate desires.

         

 Talk directly to  It reduces confusion patient. or anxiety and Speaking slowly having to process and directly. Use and respond to yes or no large amount question to of information at begin with. onetime.

 Speak in normal tones and avoid talking too fast. Give patient ample time to respond.

 Patient is not necessary hearing impaired and raising voice may irritate or anger the patient.

 Slurred speech  Limited range of motion  Irregular eating patterns  Abdominal pain  Diarrhea  Joint pain  Poor skin turgur  Thicken toe nails  Conscious and coherent

 Encourage family members and visitors to persist efforts to communicate with the patient

 It is important for family members to continue talking to the patient to reduce patients isolation, promote establishment of effective communication and maintain sense of connectedness or bonding with the family.

 Impaired  CVA can be physical caused by an occlusion in mobility related to muscular the blood flow. This involvement can lead to O2 secondary to and cause failure CVA infarct to nourish the tissues at the capillary level and that can cause neuromuscular da mage w/c can cause impaired physical mobility

 Short Term: After 4 hrs. of nursing intervention, the patient is willing to participate in activities necessary to improve his condition.  Long Term: After 3 days of nursing intervention, he will be able to improve and increase strength and function of the affected body parts.

 Determine degree of immobility.  Observe movement when client is unaware.  Support affected part with pillows.  Give rest periods to activities.  Encourage adequate fluids and right diet as necessary to the client

 To establish comparative Base line.  To note any incongruence with the reports of abilities.

 Reduce risk of pressure ulcers.

 Short Term: Goal Meet, after 4 hrs. of nursing intervention, the patient was able to participate in the different activities to improve his condition.

 To help reduce fatigue and O2 demand.  energy production

Name of Drug Generic Name: losartan 50mg 1tab

Frequency

Indications

Contraindications         

Side Effects Dizziness Cough Diarrhea Nasal congestion Heartburn Pain Dyspepsia URTI Sinus disorders

Adverse Effects  CNS: Headache, dizziness, insomnia  CV: Hypotension  Dermatologic: Rash , urticaria, pruritus, alopecia, dry skin  GI: Diarrhea, abdominal pain, nausea, constipatio n, dry mouth  Respiratory: URI symptoms, cough, sinus disorders  Other: Back pain, fever, gout, muscle weakness

Now

 Antihypertensive  Contraindicated with hypersensitivity to  Reduce risk of losartan. stroke for client with  Use cautiously with hepatic or renal hypertension dysfunction, hypovolemia

Nursing Responsibilities  Monitor for blood pressure, pulse frequently during dose adjustments  Monitor for intake and output ratios and daily weight.  Assess for signs and symptoms of CHF  Assess for signs and symptoms of Hypotension  Instruct patient to have a low fat low sodium diet regimen  Assess for signs of angioedema  Monitor BUN and serum creatinine levels  Monitor for

signs of hyperkalemia

Generic Name: simvastatin Brand Name: Zocor 10mg/tab

OD @ Hs

 Adjunct to diet  Contraindicated in the treatment with allergy of elevated to simvastatin, fungal byproducts, total cholestrol a pregnancy, lactation. nd LDL cholesterol with  Use cautiously with primary impaired hepatic and hypercholesterol emia in those renal function, unresponsive to cataracts. dietary restriction of saturated fat and cholesterol and other nonpharmacolo gic measures  To reduce the risk of coronary disease, mortality, and CV events, including stroke, TIA, MI and reduction in need for bypass surgery and angionplasty in patients with coronary heart

 muscle pain  tenderness  weakness with fever  flu symptoms  dark colored urine  headache  joint pain  constipation  mild nausea  stomach pain or indigestion  mild skin rash  sleep problems (insomnia); or  cold symptoms such as stuffy nose, sneezing, sore throat

 Body as a Whole Edema/swelling Abdominal pain  Cardiovascular System Disorders Atrial fibrillation  Digestive System Disorders Constipation Gastritis  Endocrine Disorders Diabetes mellitus  Musculoskeletal Disorders Myalgia  Nervous System/Psychiatric Disorders Headache Insomnia Vertigo  Respiratory System Disorders Bronchitis Sinusitis

 Ensure that patient has tried a cholesterollowering diet regimen for 3 6 mo before beginning therapy.  Give in the evening; highest rates of cholesterol synthesis are between midnight and 5 AM.  Arrange for regular followup during longterm therapy. Consider reducing dose if cholesterol falls below target.

disease and hypercholesterol emia Generic Name: Omeprazole 20mg/cap OD before breakfast
 Short-term  Contraindicated  Dizziness  Body As a Whole:

treatment of active duodenal ulcer  First-line therapy in treatment of heartburn or symptoms of gastroesophage al reflux disease (GERD)  Short-term treatment of active benign gastric ulcer; GERD, severe erosive esophagitis, poorly responsive symptomatic GERD;

with hypersensitivity to omeprazole or its components

confusion
 fast or

  

 

uneven heart rate jerking muscle movements feeling jittery; muscle cramps, muscle weakness or limp feeling cough or choking feeling seizure (convulsions).

Hypersensitivity reactions including anaphylaxis, anaphylactic shock, angioedema, bronchospasm, interstitial nephritis, urticaria,; fever; pain; fatigue; malaise;  Cardiovascular: Chest pain or angina, tachycardia, bradycardia, palpitations, elevated blood pressure,  Metabolism and Nutritional Disorders: Hypoglycemia, hypomagnesemia, hyponatremia, weight gain  Musculoskeletal: Muscle weakness, myalgia, muscle cramps, joint pain, leg pain, bone fracture

 Monitor for blood pressure, pulse frequently during dose adjustments  Monitor for intake and output ratios and daily weight.  Instruct patient to have a low acid diet regimen

 Nervous

System/Psychiatric: hallucinations, confusion, insomnia, nervousness, apathy, somnolence, tremors, paresthesia; vertigo Respiratory: Epistaxis, pharyngeal pain Special Senses: Tinnitus, taste perversion Ocular: Optic atrophy, anterior ischemic optic neuropathy Hematologic: hemolytic anemia, pancytopenia, neutropenia, anemia, thrombocytopenia