INTERVENTIONS

Assess ability to perform ADLs.

Encourage early mobilization (bedside
commode, chair).
Avoid doing things patient can do
for self, but provide assistance as
necessary.
Allow patient sufficient time to
accomplish tasks. Alternate rest
with activity.
Teach family techniques to care
for patient. Encourage family to
attend therapy sessions.
RATIONALE

Assessment is essential to plan appropriate

care.
Early mobilization prevents complications of
bedrest.
Independence increases self-esteem and motivation.
Too much activity without rest tires patient
and may cause frustration.
The family will be caring for patient at home
unless patient is placed in a nursing home.
INTERVENTIONS

Assess type and degree of dysfunction.

Request consult with speech therapist.
Maintain a calm, quiet, unhurried
atmosphere.
Use alternative methods of communication
as necessary (e.g.,
writing, communication board,
gestures).
RATIONALE

Assessment helps determine strategies that

will best help patient.
A speech therapist will assist with assessment
and recommendations for communication.
Distractions can be frustrating to the patient
and make communication more difficult.
Alternative methods may help patient communicate
needs.
INTERVENTIONS

Assess patients ability to chew and

swallow. Assess height and weight.
Request swallowing study/dietitian
consult if indicated.
Institute swallowing safety measures.
(See Nutrition Notes Box
46-5.)
Teach patient to chew on unaffected
side. Check affected cheek
for pocketing of food.
RATIONALE

Patient should not be fed until ability to swallow

safely is determined. Aspiration can cause
pneumonia and death.

A swallowing study can detect risk for aspiration.

A dietitian can provide foods that are
easily swallowed.
These interventions help prevent aspiration.
Patient may not be aware of foods on affected
side.