Rehabilitation Therapy for Stroke

Disability caused by the stroke, depending on which part is damaged, and how extensive the damage.

In general, defects that arise can be grouped into five, among others:

• Paralysis or impaired movement set (motor)
• Disturbance of taste (sensory), including pain
• Language disorder (aphasia)
• Impaired thinking or memory (memory)
• Emotional disturbances.

In order to overcome the problems mentioned above, then the post-stroke rehabilitation process will perform in a holistic therapy and variations, such as physical therapy, occupational therapy, speech therapy, counseling and spiritual guidance.

Let us identify what is being done therapy at rehabilitation

What is Physical Therapy?

Physical therapy or better known as a physiotherapist, is part of the Medical Rehabilitation Teams that play a role in the training of patients with abnormal posture, movement disorders and muscle problems. Physiotherapist tasks are: To assist patients in performing exercise or muscle manipulation in accordance with patients' problems, such as muscle strengthening exercises, hydrotherapy, balance and coordination exercises, stretching exercises etc.. Help patients cope with muscle problems with the tools for instruction specialist physiotherapy.

What is Occupational Therapy?

Occupational Therapy is part of a team that plays a role in Medical Rehabilitation: Helping the patient to perform fine motor movements. Train the patient in performing activities of daily living such as moving from sitting to standing, bathing, dressing, eating, etc.. Train the patient to make adaptive movements with various tools. Assist the patient in the process of returning to work.

What is Speech Therapy?

Is part of a team that plays a role in Medical Rehabilitation: Helping the patient to communicate to aid communication with exercises such as pronunciation (articulation) or with a communication tool. Help patients with swallowing disorders (dysphagia) with training / special maneuvers to facilitate the process of swallowing.

Counseling Psychology

Help provide mental support for the patient while the patient is depressed. A test of intellectual (IQ tests) when needed.

Medical Social Officer

To evaluate patient residence and employment and provide education to organize an easier place to live according to the condition of the patient performs the activity of the patient. Helped find donors when there are patients who require a fee. If necessary, helping patients to gain skills in accordance with the patient's condition, to be used for livelihood.

Spiritual director can help to support mental patients in the religious field.

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Impaired Physical Mobility related to Stroke

Nursing Diagnosis for Stroke: Impaired Physical Mobility

A stroke is also referred to as a brain attack, and it occurs when a blood vessel leading to the brain ruptures or gets blocked due to plaque deposits. When plaque accumulates on the wall of arteries, it is known as arthrosclerosis.

A stroke leads to several complications because the patient experiences weakness, paralysis and they cannot perform daily living activities. Their quality of life reduces, as they cannot shop, socialize and feed themselves. A stroke also leaves a person with visual defects and this causes them to eat their meals partially. They will consume just what they can see. The visual orientation might get affected from left to right. A visual problem can lead to the grave neglect of food and diet, and leaves a deficit in their nutrition.

Strokes affect millions of individuals around the United States each year, claiming more than 150,000 lives annually. Of those who survive, about one-third suffers from permanent disabilities. For decades, physicians have noticed that strokes impact men and women differently, though no conclusive study has discovered the reason.


Impaired Physical Mobility related to Stroke

Nursing Diagnosis for Stroke: Impaired Physical Mobility related to the involvement of neuromuscular weakness.

Expected outcomes are:

• Maintain the optimal position of function as evidenced by the lack of footdrop contracture.
• Maintain / improve strength and function of the affected body part or compensation.

Nursing Interventions for Stroke - Impaired Physical Mobility

1. Assess functional ability / extent of initial damage by way of regular, classified by scale of 0-4.

Rational: To identify strengths, weaknesses and can provide information through the recovery.

2. Change position at least every 2 hours (back, oblique) and if possible more often if placed in a compromised position.

Rational: Lowering the risk of trauma / ischemia area damaged tissue is more bad circulation and decrease of sensation and minimize pressure sores.

3. Put on the tummy one or two feet a day if the patient can tolerate it.

Rationale: Helps to maintain a functional hip extension.

4. Perform the exercise of active and passive range of motion.

Rationale: Minimizing muscle atrophy helps increase circulation mensegah contractures.

5. Chock limb in a functional position, use a board foot (food board) during the period of paralysis flaksid, maintaining a neutral head position.

Rational: To prevent contractures (foot drop) and facilitate their role if it works again.

6. Use the support arm when the patient is in an upright position, as indicated.

Rationale: During paralysis flaksid use of buffers can reduce the risk of subluksasio arm and shoulder arm syndrome.

7. The position of the knee and hip in extension position.

Rationale: Maintaining a functional position.

8. Collaboration / consultation with physiotherapists actively resistive exercises and ambulation.

Rationale: a special program can be developed to determine / find a need, which means / avoid these shortcomings in the balance, coordination and strength.

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Hemorrhoids

Hemorrhoids are massive clumps or cushions of tissue caused by swollen veins in the anal canal. Most people think this condition is abnormal but it is actually very common among men and women. This problem is most often not life threatening but can be painful.

Hemorrhoids are a very common health problem. Hemorrhoids cause serious problems in about 4% (over 10 million) of people in the United States. Prevalence of hemorrhoidal disease increases with age until the seventh decade and then diminishes slightly. Hemorrhoids also increase in pregnancy due to direct pressure on the rectal veins.

The anal canal contains a rich network of arteries that give it a constant supply of blood. This explains why bleeding from hemorrhoids is bright red rather than dark red, and why bleeding from hemorrhoids sometimes can be severe.

Causes

Most common causes of hemorrhoids:

• straining with bowel movements (from constipation or hard stools)
• diarrhea
• constant sitting
• sitting on the toilet for a long time
• childbirth
• pressure of the fetus in pregnant women
• heavy lifting
• familial tendency
• obesity

Types

If the hemorrhoid occurs inside the rectum, it is referred to as an internal hemorrhoid. If it originates at the lower end of the anal canal near the anus, it is referred to as an external hemorrhoid.

Most people do not know they have internal hemorrhoids since they are painless and cannot be seen. External hemorrhoids however can get irritated and clot under the skin, causing a pain.

Symptoms

Symptoms of hemorrhoids include:

• rectal bleeding
• pain around the anus and rectum
• irritation and itching
• bulge or lump at the anus

Physicians use a grading system to describe the severity of hemorrhoids:

1st degree - Hemorrhoids that bleed but do not prolapse.

2nd degree - Hemorrhoids that prolapse and retract on their own (with or without bleeding).

3rd degree - Hemorrhoids that prolapse but must be pushed back in by a finger.

4th degree - Hemorrhoids that prolapse and cannot be pushed back in.




Nursing Diagnosis for Hemorrhoids Before Surgery

1. Acute Pain

2. Risk for Constipation


Nursing Diagnosis for Hemorrhoids After Surgery

1. Acute pain: the surgical wound

2. Activity intolerance

3. Knowledge Deficit

4. Risk for Infection

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Nursing Care Plan for Angina pectoris - 4 Diagnosis and Interventions

1. Acute Pain related to myocardial ischemia

Nursing interventions:

• Review the description and the factors that aggravate the pain.
• Observation of vital signs every 5 minutes on each attack of angina pectoris.
• Create a quiet environment, limit the visitor when necessary.
• Put the client on total bedrest during episodes of angina (the first 24-30 hours) with a semi-Fowler position.
• Give soft foods and let the client rest 1 hour after meals.
• Teach distraction and relaxation techniques.
• Medical collaboration in terms of drug delivery.

2. Activity intolerance related to decreased cardiac output.

Nursing interventions:

• Maintain bed rest in a comfortable position.
• Provide adequate rest periods, aids in the fulfillment of self-care activities in accordance with the indication.
• Record the color and quality of the pulse.
• Increase client activity on a regular basis.
• ECG Monitor with frequent, and record ECG if there are complaints of angina pectoris.

3. Anxiety related to fear of the threat of sudden death.

Nursing interventions:

• Explain all procedures act.
• Increase expression of feelings and fear.
• Encourage family and friends to consider the client as before.
• Tell the client that the medical program has been made to reduce / limit the attack to come and increase the stability of the heart.
• Collaboration.

4. Knowledge Deficit: (need to learn) about the disease, treatment needs related to the lack of information.

Nursing interventions:

• Emphasize the need to prevent angina attacks.
• Push to avoid the factors / situations as the originator of angina episodes.
• Assess the importance of weight control, smoking cessation, dietary changes and exercise.
• Show / encourage clients to monitor their own pulse rate during the activity, avoid stress.
• Discuss the steps taken in the event of an attack of angina.
• Encourage clients to follow a predetermined program.

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