The nurse is caring for a patient suffering from left-sided hemianopsia after having a stroke. Which nursing diagnosis is priority for this patient?
Incontinence (bowel or urinary)
Impaired skin integrity
Disturbed sensory perception
Imbalanced nutrition
The Correct Answer is C
A. Incontinence (bowel or urinary): While incontinence may occur in stroke patients, it is not the primary concern for someone with hemianopsia, a visual impairment.
B. Impaired skin integrity: Although this is important, particularly for immobile patients, it is not directly related to hemianopsia.
C. Disturbed sensory perception: Hemianopsia results in the loss of half the field of vision in one or both eyes, leading to disturbed sensory perception. This is a priority because it directly affects the patient's ability to navigate their environment safely.
D. Imbalanced nutrition: Although important, this is not the immediate concern related to hemianopsia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Incontinence (bowel or urinary): While incontinence may occur in stroke patients, it is not the primary concern for someone with hemianopsia, a visual impairment.
B. Impaired skin integrity: Although this is important, particularly for immobile patients, it is not directly related to hemianopsia.
C. Disturbed sensory perception: Hemianopsia results in the loss of half the field of vision in one or both eyes, leading to disturbed sensory perception. This is a priority because it directly affects the patient's ability to navigate their environment safely.
D. Imbalanced nutrition: Although important, this is not the immediate concern related to hemianopsia.
Correct Answer is ["A","B","C","E"]
Explanation
A. Monitor pulse before taking medicine: For certain blood pressure medications, such as beta blockers or some calcium channel blockers, monitoring the pulse is important because these medications can lower the heart rate. Patients should be advised to check their pulse and report if it is too low.
B. Continue taking medications even if feeling better: It is crucial for patients to understand that antihypertensive medications manage symptoms but do not cure hypertension. Stopping the medication can lead to a rebound effect, potentially causing dangerously high blood pressure.
C. Do not skip doses: Regular intake of medication is essential for maintaining stable blood pressure levels. Missing doses can lead to ineffective control of hypertension and increase the risk of complications.
D. Eat a diet high in fats and processed food: This is incorrect. Patients should be advised to eat a healthy, balanced diet low in fats and processed foods to help manage their blood pressure and overall cardiovascular health.
E. Exercise regularly: Regular physical activity helps in controlling blood pressure and improving overall cardiovascular health. It is important to include exercise as part of lifestyle modifications for managing hypertension.
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