Activity 27.3: Critical thinking

Using the Roper-Logan-Tierney Model of Twelve Activities of Daily Living, think about caring for a patient who has had a stroke, using the model complete each of the sections and decide how you would plan your care for the patient. Refer the following link:

  • Maintaining a safe environment – A stroke patient may have difficulty maintaining a safe environment as they may have a weakness or paralysis which could impact on them.
  • Communication – A stroke patient may have communication problems.
  • Aphasia (sometimes called dysphasia) is the name for the most common language disorder caused by stroke. Aphasia can affect how you speak, your ability to understand what is being said, and your reading or writing skills. It does not affect intelligence, although sometimes people think it does.
  • Dysarthria happens when a stroke causes weakness of the muscles you use to speak. This may affect the muscles you use to move your tongue, lips or mouth, control your breathing when you speak or produce your voice.
  • Dyspraxia is a condition that affects movement and coordination. Dyspraxia of speech happens when you cannot move muscles in the correct order and sequence to make the sounds needed for clear speech.
  • Breathing – Pneumonia is one of the most common respiratory complications of acute stroke, occurring in about 5 to 9 per cent of patients. Chest infections can occur after a stroke, especially if the swallow mechanism has been affected. This makes inhalation of food par­ticles more likely, so that inflam­mation and infections occur.
  • Eating and drinking – Dysphagia is the medical term for difficulty swallowing or paralysis of the throat muscles. This condition can make eating, drinking, taking medicine and breathing difficult. Many stroke survivors experience dysphagia or trouble swallowing at some point after a stroke.
  • Elimination – The patient may be incontinent if not fully conscious, the stroke may have affected the part of the brain responsible for elimination. The patient may not be able to communicate their needs and they may be less mobile making them at risk of incontinence.
  • Washing and dressing – If the patient has a paralysis they m\y require assistance with washing and dressing.
  • Controlling temperature – Stroke patient can have problems controlling temperature if the hypothalamus has been effected.
  • Mobilisation – A stroke patient may not be able to mobilise due to paralysis or may be unsteady on their feet and are then at risk of falling.
  • Working and playing – The stroke may cause the patient to have to give up work, or certain hobbies they enjoy. This could lead to depression and anxiety.
  • Sleeping – About two-thirds of stroke survivors have sleep-disordered breathing (SDB). This type of sleep disorder is caused by abnormal breathing patterns such as with obstructive sleep apnoea. With SDB, the patients sleep is interrupted several times throughout the night. So, during the day they may be really sleepy or have trouble thinking or solving problems. SDB also poses dangerous health risks because it can increase blood pressure, heart stress and blood clotting.