In the case under analysis, a 78-year-old woman who survived a cerebrovascular accident (CVA) or a stroke is seen by a home health registered nurse. During the first initial assessment, it is necessary to pay attention to the patient’s health history, including physical changes, socio-cultural data, and mental conditions. Armstrong (2014) recommended focusing on body functions and structures, recent activity limitations and restrictions, and contextual factors to plan the patient’s care needs. Functional assessment findings include certain problems in performing activities of daily living and the inability to return to the same activities she was involved before CVA. New lifestyle habits and limitations may result and cause depression, anxiety, and other emotional changes. There are many stroke assessment scales that can be used by healthcare providers in their intention to measure patients’ functions. For example, the National Institutes of Health Stroke Scale (NIHSS) focuses on the evaluation of speech, language, sensory, muscle, vision, and coordinating functions (Taylor-Rowan, Wilson, Dawson, & Quinn, 2018). With a new-onset CVA, visual, hearing, and talking problems appear, associated with confusion, weaknesses, and loss of balance.
Despite the fact that the patient has already spent time at her daughter’s home, receiving care and support, a primary factor in getting her home should be the presence of another person in her life. This person may assist in washing, dressing, and cleaning the house. In addition, suitable adaptation is required, and its arrangement is not a single action but a result of several observations and analysis of the patient’s habits. The Barthel index is one of the possible assessment tools that a nurse applies during her initial visit to define long-term care out of healthcare settings (Taylor-Rowan et al., 2018). Its benefits include the length (about five minutes to take), validity, reliability, and a frequent application. The chosen assessment plan and attention to the details should help the nurse to evaluate the patient and contribute to her well-being.
References
Armstrong, M. (2014). Postdischarge nursing care of stroke patients.American Nurse Today, 9(2). Web.
Taylor-Rowan, M., Wilson, A., Dawson, J., & Quinn, T. J. (2018). Functional assessment for acute stroke trials: Properties, analysis, and application. Frontiers in Neurology, 9. Web.