Question

Scenario: 
You are an Enrolled Nurse assigned to care for a 47-year-old client with right-sided hemiplegia and generalised weakness after a cerebrovascular accident. It is meal time now. Read the care plan for the client and assist the client with meeting his nutritional need as advised.

Answer 1

Patients having hemiplegia and generalised weakness typically loss there appetite. Most of them may have difficulty eating using there hands or difficulty swallowing there food, so to help them increase there desire to eat you can encourage there loved ones to share a meal with them regularly, serve food that the patient usually like, encourage the patient to have healthy snacks in between meals and always monitor for any difficulty on chewing or swallowing . Patient should try first soft food or the meal should be cut on small pieces or blended, fruits should be peeled off so it is easier to ingest and lower the risk of choking.

Meal Plan:

Patient should have a well-balanced diet and should eat good fruits and vegetables.

The patient should eat high antioxidants fruits like blueberries, strawberries, oranges, grapes and mangoes it will counteract the damage from free radicals.

Patients should increase intake of vegetables high in B6 and folic acid for example green leafy vegetables, brocolli, asparagus, brussel sprouts, cauliflower and okra. The B vitamins decreases the levels of homocysteine which have been known to increase the risk for heart disease.

Patient should eat a lot of fish which is high in omega 3-fatty acids it has antioxidants and anti-inflammatory effect. Choose lean meats and poultry, and prepare them without using saturated or transfat.

Barley, rice and other soft cooked grains can be included in soup recipes and pureed or liquidised. Smooth porridges such as Tastee Wheat and Maltabella are suitable for patients with some swallowing ability.

Things to avoid:

Food high in fat like red meat, dairy products and eggs. Instead of frying learn new ways of cooking, such as baking or broiling.Avoid whole milk and try skim milk of nonfat.

Avoid alcohol.

Cut back on drinks and foods with added sugars to decrease the risk of having diabetes.

Decrease salt intake as we all know salt is directly related to high blood pressure which is a risk factor for stroke.