1. How will homonymous hemianopsia affect Suzanne\'s hygiene, eating, driving, a

Question

1. How will homonymous hemianopsia affect Suzanne's hygiene, eating, driving, and community activities?

2. What factors should the nurse assess for related to outpatient rehabilitation for Suzanne?

3. What are the priority nursing interventions for Suzanne?

4. Based on the assessment data provided, write one or more nursing diagnoses. Are there any collaborative problems?

Stroke Patient Profile Suzanne, a 66-year-old white woman, awoke in the middle of the night and fell when she tried to get up and go to the bathroom. She fell because she was not able to control her left leg. Her husband took her to the hospital, where she was diagnosed with an acute ischemic stroke. Because she had awakened with symptoms, the actual time of onset was unknown and she was not a candidate for tPA. Subjective Data «Left arm and leg are weak and feel numb · Feeling depressed and fearful .Requires help with ADLs .Concerned regarding having another stroke .Says she has not taken her drugs for high cholesterol for many weeks «History of a brief episode of left-sided weakness and tingling of the face, arm, and hand 3 months earlier, which totally resolved and for which she did not seek treatment . · BP 180/110 Left-sided arm weakness (3/5) and leg weakness (4/5) Decreased sensation on the left side, particularly the hand .Left homonymous hemianopsia .Overweight .Alert, oriented, and able to answer questions appropriately but mild slowness in responding . . Critical Thinking Questions

Explanation / Answer

1 Homonymous hemianopsia a visual field loss on the left or right side of the vertical midline affecting one eye in Suzanne's case while eating she may eat only food present in one part of plate which is visible to her, she may able to clean the body of herself only one part and other part may not be able to cleaned causing unhygienic conditions, a sense of discomfort in social communities gatherings might be felt by her fearing she may walk into people on the side where the visual field is missing, while driving she may ramp persons on other side of car who are not visible to her and she may be causing major accidents risking her life and of others.

2   Nurse should be able to counsel and motivate suzzane’s who might be fearful in moving out and living life normally, she should managed her visual impairment and proper treatment should be given. Her age and health condition should be considered while starting any treatment or therapy. Additionally, non-visual disorders related to memory, speech, cognition, emotion and paralysis may occur if proper treatment not given so proper prevention and treatment should be given to avoid these disorders.

3 Suzzane affected with stroke and left eye homonymous hemianopsia might be feared to go local grocery store or might be fearful in attending social gatherings she should be given confidence and guidance should be given while moving out she should guided and should not be left alone for long time. Citing her BP she should be counseled and appropriate treatment should be given to control her BP. Her weight should be managed with proper diet and therapy should be given for her visual impairment.

4 Observing all above symptoms we can say that increase cholesterol levels blocked of arteries causing low supply of blood to brain and increased BP leading to form of tumors and resulted in stroke which later diagnosed with Homonymous hemianopsia

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