Okay. So, we just got this why does
a patient with right-sided stroke
have a higher risk for injury due
to mobility differences?
Let's see if you can recall what we've
talked about when a patient has a stroke.
Remember, a right-sided stroke, the
patient has difficulty in judging position,
distance, and rate of movement.
That is a recipe for disaster when
a patient's walking, right?
So we know right-sided strokes, they're
going to have a real problem with that.
They're also very impulsive, they're impatient,
and they deny that they have any problems.
They say they're fine, they're fine, they're fine.
So, put bullet point number 1 and 2
together and we have a real risk for falls.
So, a right-sided stroke patient will
respond best to verbal directions.
Now, I do better seeing something written,
and then I can follow it much quicker.
Verbally, it takes my brain a
little longer to process,
but in a right-sided stroke, they're
going to do better with clear,
concise, objective directions that
you give them verbally.
Not patronizing, not using the
words "Honey" or "Sweetie,"
and not talking to them like they're a child,
but clear, concise and objective directions.
So, you want to break tasks
down into simple steps.
Don't give them multiple steps
to do at one time,
break it into simple steps and a few steps.
Make sure that you assess their environment.
Now, I don't mean to be patronizing, but
I'm saying much like we do for a toddler,
when they're just kind of learning to
walk, how we baby proof a home,
you want to stroke proof a room and a home.
So we want to make sure
the lighting is good.
We want to make sure there's
not clutter or obstacles.
You don't want throw rugs on the floor
that they could easily catch
their foot and trip on.
The footwear they're wearing needs
to be non-slip footwear.
So this patient doesn't need to be walking
on a hospital floor in regular socks,
because those are -- those are slippery.
They have those really ugly
socks in the hospital,
but they've got all the grip on the bottom.
That's what they should be wearing.
But make sure just in case
Mr. Johnson has any
edema in his lower extremities, make
sure you have the right size on him,
otherwise, we're gonna have an
issue with skin breakdown.
And if he has one-side of neglect,
you're going to address it with the nursing
interventions we've just talked about.
So, with Mr. Johnson, let's apply
what we've talked about.
He's going to be slower in organization
and performance of tasks.
So we're going to have to breathe
2 deep breaths twice
before we go in his room to
remind ourselves of that,
and then we're going to walk in and
be ready to be calm and unrushed.
So we're going to have impaired
That's not going to be a real
easy thing to see.
Gonna be a little fearful and
anxious because of the stroke
which makes perfect sense to me, no
matter what side your stroke is on,
and going to respond well
to nonverbal cues.
So, pointing, and the more
you spend time with him,
you'll learn each other's languages.
But remember, it's our job to
always remain professional.
Even if the patient is not, that's okay,
because they're going through
a really stressful experience.
My job as a nurse, I always take the
high road. I have to remain professional.
Inside my head, I may be
thinking unkind things,
but externally, it's not appropriate.
You can find a co-worker or
a counselor to debrief with,
but for the patient, no matter what
happens, no matter what they say,
no matter how they react,
our job is to remain
professional and therapeutic.