Health Teaching Strokes Dependent: 1. Evaluate type/degree of sensory-perceptual involvement. 2. Include SO/family in discussions and teaching. 3.

Discuss specific pathology and individual potentials. 4. Identify signs/symptoms requiring further follow-up, e.g.,changes/decline in visual, motor, sensory functions;alteration in mentation or behavioral responses; severeheadache. 5. Review current restrictions/limitations and discuss planned/potential resumption of activities (includingsexual relations). 6. Review/reinforce current therapeutic regimen, includinguse of medications to control hypertension,hypercholesterolemia, diabetes, as indicated; aspirin or similar-acting drugs, e.g., ticlopidine (Ticlid), warfarinsodium (Coumadin). 7. Identify ways of continuing programafter discharge. 8. Provide written instructions and schedules for activity,medication, important facts. 9. Encourage patient to refer to lists/written communicationsor notes instead of depending on memory. 10. Discuss plans for meeting self-care needs.Refer to discharge planner/home care supervisor, visitingnurse. 11. Identify community resources, e.g., National StrokeAssociation, American Heart Associations StrokeConnection, stroke support clubs, senior services, Mealson Wheels, adult day care/respite program, and visitingnurse. RATIONALE 1. Deficits affect the choice of teaching methods andcontent/complexity of instruction. 2. These individuals will be providing support/care and havegreat impact on patients quality of life. 3. Aids in establishing realistic expectations and promotesunderstanding of current situation and needs. 4. Prompt evaluation and intervention reduces risk of complications/further loss of function. 5. Promotes understanding, provides hope for future, andcreates expectation of resumption of more normal life. 6. Recommended activities, limitations, andmedication/therapy needs are established on the basis of acoordinated interdisciplinary approach. 7. Follow-through is essential to progression of recovery/prevention of complications. Note: Long-term anticoagulation may be beneficial for patients older than 45 years of age who are prone to clot formation; however, use of these drugs isnot effective for CVA resulting from vascular aneurysm/vessel rupture. 8. Provides visual reinforcement and reference source after discharge.Provides aids to support memory and promotesimprovement in cognitive skills. 9. Varying levels of assistance may be required/need to be planned for based on individual situation. 10. Home environment may require evaluation andmodifications to meet individual needs. 11. Enhances coping abilities and promotes homemanagement and adjustment to impairments for bothstroke survivors and caregivers.

Note: Recent innovationsinclude such programs as Menu-Direct, which providesfully prepared meal programs with nutrition-rich foods.Some entrees have souffllike consistency to help trigger swallowing response. Independent 1. Suggest patient reduce/limit environmental stimuli,especially during cognitive activities. 2. Recommend patient seek assistance in problem-solving process and validate decisions, as indicated.Identify individual risk factors (e.g., hypertension, cardiacdysrhythmias, obesity, smoking, heavy alcohol use,atherosclerosis, poor control of diabetes, use of oralcontraceptives) and discuss necessary lifestyle changes. 3. Review importance of balanced diet, low in cholesteroland sodium if indicated. Discuss role of vitamins andother supplements. 4. Refer to/reinforce importance of follow-up care byrehabilitation team, e.g., physical/occupational/speech/vocational therapists Rationale 1. Multiple/concomitant stimuli may aggravate confusionand impair mental abilities. 2. Some patients (especially those with right CVA) maydisplay impaired judgment and impulsive behavior,compromising ability to make sound decisions. 3. Promotes general well-being and may reduce risk of recurrence. Note: Obesity in women has been found tohave a high correlation with ischemic stroke.Improves general health and well-being and providesenergy for life activities. 4. Diligent work may eventually overcome/minimizeresidual deficits.