Question

Mrs. Kocher is a 77-year-old resident with COPD. She had a CVA which left her with right-sided hemiparesis. She was right-handed. Before admission, she was cared for in her daughter’s home. The daughter states that she fed Mrs. Kocher because the dominant hand was paralyzed. She requests that her mother be spoon-fed to prevent weight loss. Weight has been a problem for this resident in the past. Mrs. Kocher propels the wheelchair in her room. She uses her left hand and left foot. Staff push the chair in the hallway because her endurance is poor. She becomes short of breath from pushing the chair. Is this resident a candidate for a restorative feeding program? Why or why not? If you think she should be evaluated, who will you report to? What will you report?

Answer 1

RESTORATIVE FEEDING PROGRAM SHOULD BE STARTED bacause in rightsided hemiparalysis in right handed person can leads to loss of ability to eat independently ,loss of control,independence and self worth.Therfore ,it is important to attempt to restore   ability to feed themselves independently,at least to some degree,with restorative nursing programme.

goal of care

help the person to be able to do one or more of the basic activities of daily living such as walking with cane or a walker,eat on their own using special plates and utensils if needed

why restorative feeding program should be started

after this program patient will be able to eat own their own

have increased strength and endurance to carry out daily activities

PATIENT SHOULD BE EVALUATED

Assess the need for restorative program beacuse patient need muscle strengthening exercise ,the goal of these exercise may be to restore weak muscles to perform some basic activities of daily living such as combing one's hair

assess the respiratory function and level of breathing difficulty

assess the nutritional status of the patient

PERFORM Pulmonary function test -particularly spirometery to determine the severity of airflow limitation,assess response to medication and follow disease progression

Arterial blood gas analysis can help to measure the amounts of arterial gases

Patient should be consulted by respiratory therapist ( to manage breathimg difficulty) and physiotherapist to   manage disability and nutritional therapist to asess the need of special care

should be reported for  rehabilitation program