Page 2024 - Saunders Comprehensive Review For NCLEX-RN

to recommend consistency of food and fluids.
9. When the client is eating, position the client sitting in a
chair or sitting up in bed, with the head and neck
positioned slightly forward and flexed.
10. Place food in the back of the mouth on the unaffected
side to prevent trapping of food in the affected cheek.
H. Interventions in the chronic phase of stroke

1. Neglect syndrome

a. The client is unaware of the existence of
her or his paralyzed side (unilateral
neglect), which places the client at risk
for injury.
b. Teach the client to touch and use both
sides of the body.

2. Hemianopsia

a. The client has blindness in half of the
visual field.
b. Homonymous hemianopsia is
blindness in the same visual field of
both eyes.
c. Encourage the client to turn the head to
scan the complete range of vision;
otherwise, she or he does not see half
of the visual field.
3. Approach the client from the unaffected side.
4. Place the client’s personal objects within the visual
field.
5. Provide eye care for visual deficits.
6. Place a patch over the affected eye if the client has
diplopia.
7. Increase mobility as tolerated.
8. Encourage fluid intake and a high-fiber diet.
9. Administer stool softeners as prescribed.
10. Encourage the client to express her or his feelings.
11. Encourage independence in activities of daily living.
12. Assess the need for assistive devices such as a cane,
walker, splint, or braces.
13. Teach transfer technique from bed to chair and from
chair to bed.
14. Provide gait training.
15. Initiate physical and occupational therapy for
assessment and the need for adaptive equipment or
other supports for self-care and mobility.
16. Refer client to a speech and language pathologist as
prescribed.

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