Assessment Subjective: ´marigatan nak nga mangikuti daytoy imak ken sakak ditoy right side koµ ´Marigatan

nak pay nga agsao kas iti normalµ ´naulaw nak idi rabii nakong ngem inturog ko lattanµ Objective: Head well rounded Presence of white hair Hair evenly distributed (-) alopecia No scars noted on the head Symmetrical face Eyelids aligned Altered vision Snoring while sleeping Dry lips

Diagnosis  Impaired verbal communicatio n related to decrease faci al and oral muscle tone control as evidence by slurred speech.

Analysis  stroke happens when the blood supply to the brain is disturbed in some way. As a result, brain cells are starved of oxygen. In some cases the cerebellum is greatly degrade of oxygenation causing the brain cells in this part to die. The function of this part of the brain includes the center for speech, as an effect the patient experience having a slurred speech

Nursing Objectives  After 8 hrs. of nursing intervention, the patient will demonstrate better communicati on in expressing his needs.



Evaluation  Goal Meet. After 8 hrs. of nursing intervention, the patient was able to demonstrate a better commu nication in which needs had been expressed. 

Provide  Provide alternative communication methods of needs or desires communication based on individual , like pictures or situation or visual cues, underlying deficit. gestures or

Anticipate and provide for patient·s needs. 

Helpful in decreasing frustration when dependent on others and unable to communicate desires. 


Talk directly to  It reduces confusion patient. or anxiety and Speaking slowly having to process and directly. Use and respond to yes or no large amount question to of information at begin with. onetime. 

Speak in normal tones and avoid talking too fast. Give patient ample time to respond. 

Patient is not necessary hearing impaired and raising voice may irritate or anger the patient.

. promote establishment of effective communication and maintain sense of connectedness or bonding with the family. Slurred speech  Limited range of motion  Irregular eating patterns  Abdominal pain  Diarrhea  Joint pain  Poor skin turgur  Thicken toe nails  Conscious and coherent  Encourage family members and visitors to persist efforts to communicate with the patient  It is important for family members to continue talking to the patient to reduce patient·s isolation.

 Give rest periods to activities.  Short Term: Goal Meet. of nursing intervention.  Determine degree of immobility. This involvement can lead to O2 secondary to and cause failure CVA infarct to nourish the tissues at the capillary level and that can cause neuromuscular da mage w/c can cause impaired physical mobility  Short Term: After 4 hrs.  Observe movement when client is unaware. the patient is willing to participate in activities necessary to improve his condition. he will be able to improve and increase strength and function of the affected body parts. of nursing intervention.  energy production .  Long Term: After 3 days of nursing intervention.  Reduce risk of pressure ulcers.  To note any incongruence with the reports of abilities. after 4 hrs.  To help reduce fatigue and O2 demand. the patient was able to participate in the different activities to improve his condition.  Encourage adequate fluids and right diet as necessary to the client  To establish comparative Base line. Impaired  CVA can be physical caused by an occlusion in mobility related to muscular the blood flow.  Support affected part with pillows.

abdominal pain. muscle weakness Now  Antihypertensive  Contraindicated with hypersensitivity to  Reduce risk of losartan. dry skin  GI: Diarrhea.  Assess for signs and symptoms of CHF  Assess for signs and symptoms of Hypotension  Instruct patient to have a low fat low sodium diet regimen  Assess for signs of angioedema  Monitor BUN and serum creatinine levels  Monitor for . gout. fever.Name of Drug Generic Name: losartan 50mg 1tab Frequency Indications Contraindications          Side Effects Dizziness Cough Diarrhea Nasal congestion Heartburn Pain Dyspepsia URTI Sinus disorders Adverse Effects  CNS: Headache. pulse frequently during dose adjustments  Monitor for intake and output ratios and daily weight. urticaria. dry mouth  Respiratory: URI symptoms. insomnia  CV: Hypotension  Dermatologic: Rash . stroke for client with  Use cautiously with hepatic or renal hypertension dysfunction. pruritus. dizziness. alopecia. sinus disorders  Other: Back pain. nausea. cough. constipatio n. hypovolemia Nursing Responsibilities  Monitor for blood pressure.

sneezing. dietary restriction of saturated fat and cholesterol and other nonpharmacolo gic measures  To reduce the risk of coronary disease. and CV events.signs of hyperkalemia Generic Name: simvastatin Brand Name: Zocor 10mg/tab OD @ Hs  Adjunct to diet  Contraindicated in the treatment with allergy of elevated to simvastatin. highest rates of cholesterol synthesis are between midnight and 5 AM. lactation. Consider reducing dose if cholesterol falls below target. mortality. nd LDL cholesterol with  Use cautiously with primary impaired hepatic and hypercholesterol emia in those renal function. unresponsive to cataracts. sore throat  Body as a Whole Edema/swelling Abdominal pain  Cardiovascular System Disorders Atrial fibrillation  Digestive System Disorders Constipation Gastritis  Endocrine Disorders Diabetes mellitus  Musculoskeletal Disorders Myalgia  Nervous System/Psychiatric Disorders Headache Insomnia Vertigo  Respiratory System Disorders Bronchitis Sinusitis  Ensure that patient has tried a cholesterollowering diet regimen for 3² 6 mo before beginning therapy. including stroke. MI and reduction in need for bypass surgery and angionplasty in patients with coronary heart  muscle pain  tenderness  weakness with fever  flu symptoms  dark colored urine  headache  joint pain  constipation  mild nausea  stomach pain or indigestion  mild skin rash  sleep problems (insomnia). or  cold symptoms such as stuffy nose. TIA.  Give in the evening. . fungal byproducts. total cholestrol a pregnancy.  Arrange for regular followup during longterm therapy.

weight gain  Musculoskeletal: Muscle weakness. hypomagnesemia. anaphylactic shock. fever. palpitations. joint pain. with hypersensitivity to omeprazole or its components confusion  fast or      uneven heart rate jerking muscle movements feeling jittery. pulse frequently during dose adjustments  Monitor for intake and output ratios and daily weight. interstitial nephritis. myalgia. bone fracture  Monitor for blood pressure..  Cardiovascular: Chest pain or angina. bradycardia. poorly responsive symptomatic GERD.  Instruct patient to have a low acid diet regimen . urticaria. severe erosive esophagitis. leg pain. malaise. bronchospasm.disease and hypercholesterol emia Generic Name: Omeprazole 20mg/cap OD before breakfast  Short-term  Contraindicated  Dizziness  Body As a Whole: treatment of active duodenal ulcer  First-line therapy in treatment of heartburn or symptoms of gastroesophage al reflux disease (GERD)  Short-term treatment of active benign gastric ulcer. muscle cramps. pain.  Metabolism and Nutritional Disorders: Hypoglycemia. muscle weakness or limp feeling cough or choking feeling seizure (convulsions). muscle cramps. elevated blood pressure. GERD. Hypersensitivity reactions including anaphylaxis. fatigue. hyponatremia. angioedema. tachycardia.

apathy. neutropenia. paresthesia. vertigo Respiratory: Epistaxis. insomnia. somnolence. Nervous     System/Psychiatric: hallucinations. taste perversion Ocular: Optic atrophy. anterior ischemic optic neuropathy Hematologic: hemolytic anemia. confusion. thrombocytopenia . anemia. pharyngeal pain Special Senses: Tinnitus. nervousness. pancytopenia. tremors.

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