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Chapter 4: Problem 91

In caring for a patient recovering from cardiovascular accident (CVA) of the middle cerebral artery, the nurse notices that only half of the patient's lunch tray is eaten. The patient may be experiencing which complication of a CVA? 1\. ptosis 2\. olfactory dysfunction 3\. homonymous hemianopia 4\. judgment alteration

Short Answer

Expert verified
The patient may be experiencing homonymous hemianopia.

Step by step solution

01

Review Each Complication

Each option represents a possible complication resulting from a cerebrovascular accident (CVA). We need to understand what each term means to proceed with selecting the correct one. 1. Ptosis is a drooping of the upper eyelid due to paralysis or disease. 2. Olfactory dysfunction is an issue with the sense of smell. 3. Homonymous hemianopia is a loss of half the field of vision on the same side in both eyes. 4. Judgment alteration refers to impaired decision-making skills.
02

Match Symptoms with Complications

The symptom observed is that the patient is eating only half of the lunch tray. Let's see which complication matches this symptom: - Ptosis and olfactory dysfunction are unlikely causes, as they relate to vision problems or smell. - Homonymous hemianopia, which results in partial vision loss, may lead a patient to only see half of their tray, causing them to eat only the visible portion. - Judgment alteration could lead to erratic eating habits, but does not specifically explain eating only half the tray.
03

Choose the Most Likely Complication

Considering the symptom of eating only half of the tray, the most directly related complication is homonymous hemianopia. This condition affects vision, which explains why the patient might not see the other half of their meal.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Cerebrovascular Accident (CVA)
A Cerebrovascular Accident (CVA), commonly referred to as a stroke, happens when the blood supply to a part of the brain is interrupted or reduced. This lack of blood flow prevents brain tissue from getting oxygen and nutrients, causing brain cells to die in minutes. CVAs can result from a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). When caring for patients with CVAs, it's critical for nurses to understand several aspects:
  • Causes: High blood pressure, smoking, diabetes, high cholesterol, and a sedentary lifestyle are significant risk factors.
  • Symptoms: Sudden weakness or numbness in the face, arm, or leg, particularly on one side of the body, confusion, trouble speaking, seeing, or walking.
  • Early Action: Quick response is essential to minimize brain damage. Recognizing CVA symptoms and getting emergency medical help is vital.
Understanding the intricacies of CVA aids in timely identification and appropriate intervention, crucial for better recovery outcomes.
Patient Care
Patient care encompasses all activities that nurses conduct to ensure the physical and emotional well-being of patients. This includes monitoring vital signs, administering medications, and addressing both physical and emotional needs of patients. One critical aspect is creating a supportive environment conducive to healing:
  • Communication: Good communication ensures that patients and caregivers understand each other. This fosters trust and compliance with treatment plans.
  • Delicate Care: Adjusting care routines to accommodate patients' unique conditions, such as those who have suffered a CVA.
  • Interdisciplinary Collaboration: Nurses often work as part of a multidisciplinary team, coordinating with doctors, therapists, and social workers to provide holistic care.
Through attentive patient care, nurses can help manage complications, encourage rehabilitation, and enhance overall patient satisfaction.
Visual Impairments in Nursing
Visual impairments, such as homonymous hemianopia, are significant complications in patients recovering from a CVA. Homonymous hemianopia results from damage to the brain that affects vision, leading to the loss of half the field of view on the same side in both eyes. Nurses dealing with such impairments should consider the following:
  • Assessment: Regularly assessing a patient's vision capabilities helps tailor a care plan that accommodates their specific visual limitations.
  • Adaptation Strategies: Aids like using contrasting colors for eating utensils or rearranging the environment to suit the patient's visual field can enhance independence.
  • Education: Teaching patients and families about the condition helps manage expectations and improves adherence to adaptations.
By understanding and addressing visual impairments, nurses can help patients navigate their environment more safely and effectively.
Nursing Assessments
Nursing assessments are a foundation of nursing practice. They involve gathering comprehensive information about a patient's physical, psychological, and social health. Nurses use this data to identify needs and craft individualized care plans. For CVA patients, assessments are particularly vital:
  • Initial Assessment: Conduct a thorough initial assessment post-CVA to understand the extent of neurological damage and identify urgent care needs.
  • Ongoing Evaluation: Regular checks of neurological functions, mobility, and perceptual capabilities help in adjusting care as recovery progresses.
  • Holistic Approach: Consider emotional well-being alongside physical health, as strokes can significantly impact mental health.
Comprehensive nursing assessments ensure that care plans remain relevant and effective, facilitating better recovery outcomes and maintaining patients' quality of life.

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Most popular questions from this chapter

A client reports that someone is in the room and trying to kill him. The nurse's best response would be: 1\. "There is no one in your room. Let's get you more medicine." 2\. "I do not see anyone, but you seem to be very frightened." 3\. "No one can hurt you here." 4\. "Just tell the person to go away."

A client diagnosed with bipolar disease is running in the halls and entering other client's rooms. Select the nurse's best response. 1\. "You need to walk with me to get some medicine to help you calm down." 2\. "You need to stay out of other peoples rooms." 3\. "If you cannot stay in the living area, you will need to stay in your room." 4\. "Why are you running in the halls?"

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When a woman reports domestic violence the nurse would: 1\. seek verification from a second source. 2\. not mention the subject again because it is too sensitive. 3\. enforce that the client is not responsible or to blame. 4\. ask why the client did not report this when it started.

A client agrees to stop using marijuana. Select the best information for the nurse to teach the client about marijuana withdrawal. 1\. Marijuana is not associated with withdrawal symptoms. 2\. Seizures often occur during marijuana withdrawal. 3\. The client might have flashbacks for months after abstaining from marijuana. 4\. Dry mouth and nose are common symptoms during marijuana withdrawal.
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