HEALTH EDUCATION PLAN Name of patient: Ms.

Gumiho Room Number: 279 Chief Complaints: right sided body weakness Diagnosis/Impression:Cerebrovascular Accident Attending Physician: Dr. Rowena Delorino, Dr. Anzano Objectives: 1. Within 15-30 minutes of providing information, the SO will be able to identify specific nutritional diet necessary for stroke patient. 2. Within 1 day of giving health teaching, the patient will be able to know proper bowel movement necessary for eliminating incontinence. 3. Within 2 day of providing appropriate health teachings, the patient will be able to know the importance of exercises, therapies and maintain good health for stroke patient. 4. Within 2 days of providing health teachings, the SO will be able to verbalize understanding about health teaching and able to apply to the patient. Gender: Female Date: July 6, 2011

Materials Needed: -Markers and pen -Fact sheets -Nutritional food chart General Health Teaching Exercise and therapies Specific Health Teaching -Instruct patient to perform exercises to evaluate range of motion, strength on the affected and unaffected side, bed mobility, transfer from bed to wheelchair, balance and gait. Passive Range of Motion. When patient suffered paralysis on one side of the body, passive range of motion exercises on the shoulder, elbow, writ, fingers, hip, knee, ankle, foot, and toes. These are to maintain good blood flow and keep the muscles and tendons flexible, preventing the joints from tightening. Active Range of Motion. When patient starts to recover and begins to have voluntary muscle strength on the involved. Instruct the patient to do active exercises such as lifting or moving the body part through the range of motion against gravity without the help. These exercises help to strengthen the muscle on the weak side, but also should be done on the good side. Physical therapy-is the cornerstone of the rehabilitation process. It is concerned with identifying and maximizing movement potential within the spheres of promotion, prevention treatment and rehabilitation. It involves the interaction between physical clients, families and care givers, in a processing of assessing movement

potential and in establishing agreed upon goals and objectives using knowledge and skills unique to physical therapist. Balance and Transfer Exercises. With the assistance of a physical therapist, the patient will practice moving from lying to sitting position and then practice sitting balance. Next they will learn to transfer from bed to wheelchair and back to be sometimes using a sliding board if necessary. Gait Training Exercises. With the assistance of physical therapist, the patient can generally starts practicing standing up in the parallel bar. Next the patient learns to shift weight from one leg to the other, shifting both from side to side and from front to back. Occupational Therapy gives people the skills for the job of living. OT involves exercise and training to help the stroke patient relearn everyday activities sometimes called the activities of the daily living (ADLs) such as eating, drinking, and swallowing, dressing, bathing, cooking, reading and writing and toileting. Speech and Language Therapy is appropriate for patients with problems understanding speech or written words, or problems forming speech. Diet -Encourage patient to eat soft foods to chew and swallow it easily. -Instruct to eat on the unaffected side of the mouth and hand -Ensure patient to wear dentures and eyeglasses if needed. -Provide patient appropriate utensils such as drinking straw, food guard, rocking knife, nonskid place mat to aid in self-feeding. -Place patient in optimal position for feeding, preferably sitting up in a chair, support up in a chair, support arms, elbows, and wrists as needed. -If patient has visual problems, instruct the patient about the placement of the food in the place. -Provide information to patient and SO about the kinds of food to eat and to avoid. Foods to eat Foods to avoid -whole grains -foods high in fat, esp. -potatoes red meat, dairy -sweet potatoes products and eggs -squash -sugar -soybeans (tofu) -salt: minimize the intake -green and yellow of salt because salt vegetables creates high blood -round vegetables pressure a major cause -root veggie(carrots) of stroke -mild spices and -alcohol cooking herbs -tobacco

Grooming

-Place the patient in wheelchair or stationary chair. This assist with support when dressing. Dressing can be fatiguing. -Encourage use of clothing one side larger. This ensures easier dressing and comfort. -Suggest elastic shoelaces or loop and pile closure shoes. These eliminate tying. -Instruct patient to select bath time she is rested. Hurrying may result in accidents and the energy required for these activities may be substantial. -Provide patient with appropriate assistance devices (e.g. long-handled bath sponge, shower chair, safety mats for floor, grab bars for bath or shower). These aids in bed bathing. -Encourage patient to perform minimal or oralfacial hygiene as soon after rising as possible. Assist with brushing teeth and shaving, as needed. -Assist patient with care of finger nails and toenails as required. These reduce injury. -Offer bedpan or place patient or toilet 1 to hour during day and 3 times during night. This eliminates incontinence. Time intervals can be lightened as the as the patient begins to express the need to toilet on demand. -Encourage patient to use the strong side (if appropriate) as best as possible. -When transferring to wheelchair, always place chair on patients stronger side at slight angle to bed and lock brakes. -Instruct SO to stand on patients weak side and place hand under patients weak arm. -Encourage to use ambulation devices such as walker and crutches. -Instruct the SO to recognize distinctive characteristics of the medication. -Inform the SO on possible adverse effects of each medication and how to relieve or prevent certain side effects such as orthostatic hypotension, headache, dizziness, lightheadedness, fainting, GI upset etc. -Promote rest and minimize unnecessary disturbances such a providing fresh, calm and quiet environment -Instruct the SO notify the physician, when he/she notices any complication and unusual changes in the patients condition. It is very important to have an OPD visit after hospitalization as ordered by the physician.

Hygiene

Bowel Movement

Transferring/Ambulation

Medication

Rest and sleep

OPD

Spiritual Support

-Encourage patient to seek spiritual support such as praying to the Almighty Father, reading inspirational and scriptural readings etc. -Encourage SO to pray together with the patient. -Seek Gods presence through prayers and believe that with God there is hope.