The educator on a rehabilitation unit is teaching a graduate nurse (GN) about caring for clients who have had a stroke. Which of the following statements by the GN indicate correct understanding of the teaching? Select all that apply. A)"Approach clients with visual impairment from the affected side when entering the room." B)"Instruct clients with unilateral weakness to dress by donning clothes on the affected side first." C)"Provide written instructions for activities of daily living to clients with receptive aphasia." D)"Teach clients with left-sided neglect to turn their heads to scan the environment." E)"Teach families of clients with right-sided stroke to expect impulsive behaviors."

Question

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Clients with unilateral weakness from stroke may have limited mobility and control on the affected side. Clients being taught to dress independently should first clothe the affected side, which decreases the need for movement of impaired extremities and allows unrestricted use of unaffected limbs for assistance (Option B). Unilateral neglect is an alteration in sensory perception that causes clients to ignore input from the affected side, leading to performing actions only on one side (eg, eating food on only the right side of the plate). Teaching clients to turn the head to fully scan the environment reduces the tendency to neglect one side (Option D). Clients with right-sided cerebrovascular accidents tend to be impulsive and unaware of deficits. Teaching the client's family to expect disinhibition and emotional outbursts helps family members cope with the behavioral changes and reduces frustration during interactions (Option E). (Option A) The nurse should approach clients with unilateral blindness from the unaffected side to avoid startling the client. (Option C) Receptive aphasia (ie, Wernicke aphasia) is impairment of verbal and written language comprehension. Visual aids and hand gestures may be more effective means of communication. Educational objective: Neurological impairments from a stroke may include unilateral weakness and neglect, impulsiveness, and aphasia. The nurse should teach the client methods to improve visual perception (eg, turning head to affected side, scanning the environment) and overcome unilateral weakness (eg, dressing affected side first).

The Educator on a Rehabilitation Unit Is Teaching a Graduate