Critical Nursing Care: Plan of Care for Patients with Cerebral Vascular Attack

Running head: CRITICAL NURSING CARE
CRITICAL NURSING CARE
Name of the Student:
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1CRITICAL NURSING CARE
Table of Contents
Introduction......................................................................................................................................2
Plan of Care.....................................................................................................................................2
Impaired Verbal Communication................................................................................................3
Self Care Deficit..........................................................................................................................3
Risk for Impaired Skin Integrity..................................................................................................4
Risk for Injury..............................................................................................................................5
Impaired Physical Mobility.........................................................................................................5
Deficient Knowledge...................................................................................................................6
Legal and Ethical Considerations for the Care................................................................................6
Inter Professional Collaboration and referral..................................................................................7
Conclusion.......................................................................................................................................7
Reference:........................................................................................................................................9

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1. Introduction
The case study is about the 83 years old patient Harold Graeme Blake, who has a past
medical history of left cerebral vascular attack or CVA and Angina and is admitted in the
hospital with an episode of Angina and another cerebral vascular attack. He got the attack while
he was waiting for taxi on his way to hospital for outpatient appointment and thus, he is admitted
in the emergency department. The purpose of the paper is to provide a plan care for the patient
based on second day observation. The following paper will discuss briefly about the consequence
of CVA regarding deficient knowledge, impaired verbal communication, impaired skin integrity,
self-care deficit, impaired mobility and risk of injury. The paper will discuss about the effective
intervention, short-term and long-term goal in order to provide better care service to the patient.
The assignment will provide an idea about the ethical and legal consideration and inter
professional collaboration regarding the care, which could help Harold to get rid of the illness in
an effective manner.
2. Plan of Care
Plan of care or care plan is defined as the outline of nursing process that includes all
central requirements of the patient and effective strategies for meeting them. It is a process of
documentation during the time of admission of the patient and remains in the state of continuous
change by the caring staff of the patient according to the diagnosis, possible intervention and
expected outcomes in order to ensure the consistency of the care service. It helps the nursing
staffs to communicate and organize the process of care in order to provide fruitful outcomes
(Alligood 2013).

3CRITICAL NURSING CARE
2.1 Impaired Verbal Communication
Impaired verbal communication is one of the major problems that causes due to CVA.
CVA interferes in the process of cerebral circulation, which results in neuromuscular damage
(De-Marchis et al. 2014). The consequence of the incident includes general fatigue, limited
movement of the muscle and oral weakness, thus, the patient could suffer from improper
verbalization (Mazaux et al. 2013). It is important to include the communication issues of Harold
in the care plan in order to understand the level of difficulties. The effective intervention should
contain comfortable communication process. The nurses need to understand the needs of the
patient and observe the non-verbal cues of the patient. Nurses should maintain unhurried manner
and calm process during communicating with the patient (Gregory and Bryan 2015). Destructive
objects such as television, radio or phone need to be kept away during the time of conversation.
It is important to provide ample time to the patient to respond so that he feels comfortable;
otherwise, it could act as a trigger to Angina. The short-time goal regarding this is to help Harold
to understand words and long-term goal is to improve his communication skill. Further, the
patient could refer to a speech therapist that can communicate and understand the problem in an
effective manner and provide proper therapies to counter the issue.
2.2 Self Care Deficit
Self-care deficit is the secondary consequence of CVA (Clark et al. 2014). It is mainly
caused due to the destruction of motor neuron (De-Marchis et al. 2014). As a result, the patient
face difficulties in activities of daily living or ADLs, for example, the patient faces problem
related to eating, dressing, bathing and other regular activities. Thus, the plan of care should
include proper care process in order to address the problem of self-care deficit (Clark et al.
2014). The interventions should include providing adequate resources to make the patient self-