Figure 17-4
This concept map identifies self-care problems for John Brown, a 58-year-old man, admitted to the medical
ward with a medical diagnosis of a right-sided stroke
Unit III Thoughtful practice and the process of care
312
Bowel and
bladder
elimination
Hygiene and skin
Nutrition
Transferring
Sitting
Standing
One-sided
vision loss
Blurred vision
Double vision
John Brown
Confusion
Poor
comprehension
Mobilising
Impaired
activities of
daily living
Impaired
mobility
Impaired
vision
Impaired
cognition
Case history
Mrs Jones is a 76-year-old woman who has been admitted to
your unit with a diagnosis of transient ischaemic attack. Her
husband passed away 6 months ago and Mrs Jones has
moved in with her daughter Lisa after selling the family home.
Her daughter is with her as you take the assesment history.
Assessment findings
Subjective data
‘Will I get a stroke now? I don’t think I could handle that.’
‘How can I help myself prevent it?’
Her daughter reports her mother had been a very inde-
pendent, strong woman in the past and seemed to ‘crumple’
after her husband’s death.
Objective data
Admitting diagnosis: Transient ischaemic attack (TIA)
BP: 184/120
Past history of headaches
Identified health problems
Problem 1
•
Lack of knowledge relating to preventing further TIA
or stroke
Problem 2
•
Inability to cope with illness, recent death of husband
and relocation with daughter
Planning achievable goals
Before discharge, Mrs Jones will:
•
Describe the terms ‘TIA’ and ‘stroke’, identifying the
underlying disease process, causes and symptoms
•
Correctly describe the treatment plan:
1. Medications (drugs, intended effect, dose, time,
route)
2. Dietary modifications
3. Exercise prescription
4. Signs and symptoms to report
5. Follow-up appointment date.
After consultation with the social worker, Mrs Jones will:
•
Verbalise her feelings related to the loss of her
husband, loss of her family home, loss of her health
•
Identify personal strengths and supports that will help
her now.
Before discharge, Mrs Jones will:
•
Verbalise that she feels ‘okay’ (sufficiently in charge of
her life) about returning home.
Rationale
Each person’s learning needs are different; each person
learns in their own unique way; learning is dependent
on readiness.
Problem 1 care interventions
1. Assess what Mrs Jones knows about TIA and stroke
(correct any misinformation). Assess learning needs,
readiness to learn and factors that will influence
learning.
S T U D E N T P L A N O F C A R E 1 7 - 1
for Mrs Jones
