Introduction
Hemiplegia is a condition of partial paralysis of the body, usually affecting one side. It is commonly associated with stroke or other brain injuries. A nursing care plan for hemiplegia focuses on decreasing the effects of paralysis and developing the patient’s independence, mobility, and self-care capabilities.
Assessment
An assessment for a care plan of hemiplegia includes determining the location, severity, and type of paralysis. The medical history and physical examination also provide valuable information to develop a plan of care.
Nursing Diagnosis
A nursing diagnosis identifies problems typically related to hemiplegic conditions. Common diagnoses include:
- Ineffective Airway Clearance
- Risk for Injury
- Ineffective Therapeutic Regimen Management
- Imbalanced Nutrition, Less Than Body Requirements
- Knowledge Deficit related to Disease Process
Outcomes
The outcomes include state goals that must be achieved for the patient. Examples of possible outcomes may include:
- Participates in self-care activities
- Stays free of injury or complications from paralysis
- Engages in social contacts
- Maintains mobility and strength within limitations
- Expresses knowledge regarding care methods
Interventions
Interventions provide strategies to reach the desired outcomes of the care plan. These interventions may include:
- Include patient and family members in care
- Encourage the use of assistive devices
- Monitor range-of-motion exercises
- Provide patient education
- Administer medications as prescribed
- Establish regular nutritional intake
Rationale
The rationale for interventions explains why they should be used in a particular situation. Rationales for interventions for hemiplegia include:
- Assistive devices increase independence and decrease potential for injury
- Education helps the patient gain understanding of the disease process
- Exercises help maintain muscle tone and range of motion
- Regular nutrition improves general health
- Medications may help improve mobility and reduce pain
Evaluation
The evaluation phase reviews the patient’s progress and determines whether the goals have been met. For hemiplegia, evaluation should look at the patient’s mobility, self-care activities, and participation in daily activities.
Conclusion
A nursing care plan for hemiplegia can help guide care and provide support for the patient. The plan focuses on decreasing the effects of paralysis and promoting the patient’s independence.
FAQs
- What is Hemiplegia?
Answer: Hemiplegia is a condition of partial paralysis of the body, usually affecting one side. - What is included in the assessment for the care plan?
Answer: The assessment includes determining the location, severity, and type of paralysis. - What are examples of nursing diagnoses related to hemiplegia?
Answer: Common diagnoses include ineffective airway clearance, risk of injury, ineffective therapeutic regimen management, imbalanced nutrition, and knowledge deficit. - What are some interventions for the care plan?
Answer: Interventions may include including patient and family members in care, encouraging use of assistive devices, monitoring range-of-motion exercises, providing patient education, administering medications, and establishing regular nutrition. - What is the purpose of the evaluation phase?
Answer: The evaluation phase looks at the patient’s progress and determines if the goals have been met.