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Stroke: Part II

LTC Nursing Assistant Trainer, December 15, 2004

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Your residents who have had a stroke need special nursing care for the complications related to paralysis or partial paralysis. Consider the following when caring for a stroke resident:

• Decubitus ulcers
  Special mattresses and pads, proper skin care and frequent turning can prevent or minimize the occurrence of pressure ulcers. Always follow your facility's policies and procedures concerning decubitus ulcers.
• Contractures
  Proper body alignment must be maintained to prevent contractures. Take special care to maintain residents' feet in their normal position.
• Pneumonia
  Frequent turning and position changes move the fluid that collects in the lungs. Great caution should be taken when feeding a partially paralyzed resident to prevent aspiration pneumonia. Encourage the resident to cough often, as this reduces the amount of mucus in the lungs.
• Urinary and fecal incontinence/retention
  This is a very common result of a stroke. Recording intake and output and bowel habits permits early intervention before a problem becomes too serious. Get the resident on a regular toileting schedule or offer the bedpan at regular intervals.
• Falls
  Stroke residents have a distorted sense of the location of the affected side of the body. Assist the person with ambulating and transferring until you determine it is safe without you.

Physical, occupational, and speech therapy can greatly improve the status of a resident who has had a stroke. In addition, family members and staff have a tendency to do too much for stroke residents. Although you should help with things they are unable to do on their own, the more stroke residents are encouraged to do, the better they feel and the more complete the recovery.

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