Unilateral Neglect Care Plan in Nursing

How can unilateral neglect care plan be defined? That is a set of procedures developed to address impairment in the motor and sensory responses, spatial attention, mental representation, and environment with over-attention and insufficient attention. Neglect of left side exceeds in that of right side in persistence and severity.

Key Characteristics of the Nursing Care Plan Unilateral Neglect

  • Permanent lack of attention to positioning and stimuli on the right or left side
  • Inability to eat using a plate on the right or left side
  • Improper self-care
  • Inability to move arms, legs, head, eyes, or body in the affected part in spite of the awareness regarding the space stimulus
  • Deviation of the head, eyes, or body to the non-affected side by activities and stimuli on the affected side
  • Observed perseveration on the non-affected side related to the tasks of visual motor direction

Corresponding Factors

  1. Injury of the brain caused by either tumor or causes of neurological, cerebrovascular, or traumatic nature
  2. Hemianopsia
  3. Left hemiplegia caused by right hemisphere CVA

Focus of the Assessment

  • Exercising and activity
  • Integrity of tissue
  • Self-care
  • Coping with tasks
  • Perception and sensation
  • Neuro-cognition

Expected Outcomes

According to the unilateral neglect nursing care plan, patients will be able to:

  • Recognize the part of the body that was neglected.
  • Avoid breakdown of the skin, injuries, or contractures on the parts of the body that is affected.
  • Show exercising for the body part.
  • Show the required measures aimed at the best functioning and do the required arrangements for the protection of the affected part of the body.
  • Demonstrate feelings regarding the neurologic deficiency and changed state of health.
  • Do the identification of the resources of the community and support groups to assist in coping with the consequences of the illness.

Assumed Outcomes

  1. Body image.
  2. Adaptation to physical disabilities.
  3. Performance of the body mechanics.
  4. Self-care.
  5. Positioning of the body.
  6. Self initiation.
  7. ADLs.

Nursing Interventions and Rationales

What should be determined? There should be observation of how the affected part of the body positioned for injury prevention.

What should be performed? It is required to put a sling on the arm affected arm for the prevention of injuries or dangling. The affected leg should be supported together with a number of other taken measures for maintaining the functional position of the arms and legs of the patient as well as avoiding the contractures.

A nursing care plan neurological impairment implies using a draw-sheet for transporting the patient in the bed aimed at preventing abrasions of the skin. It is necessary to rub the arm or leg and talk about it with the patient, who is supposed to remember about the neglected limb. It is recommended to apply protective devices and safety belts for the prevention of falls and reminding the patient about possible injuries. The devices should be used in accordance with the facility policy. All devices and splints should be removed e3very two hours or even more frequently. The skin should be observed to see if there are any pressure zones. The unilateral neglect care plan requires reapplying the devices and splints properly to ensure that the skin is integral and the deformities are prevented.

Moreover, the affected side should be involved in the performance of the ROM exercises and activities minimum one time during the shift to prevent the contractures and ensure the flexibility of joints, with the exception of medically contraindicated cases. Maintenance of skin integrity can be ensured only if the schedule of turning is established and followed. The environment should be arranged for ensuring the best possible functioning so that the patient could take the TV control, a bottle of water, or reach the bell easily. Those simple measures contribute to the encouragement of independence of the patient and enhance his or her orientation in the environment. A nursing care plan for self care deficit related to stroke and other health issues anticipates giving supervision or helping the patients to ensure the protection of the affected parts of the body.

The patient should be motivated to engage in the activities which involve the affected limbs. It is important to talk to the personnel and the family about the necessity to monitor the affected limb position as frequently as required, to change the position if needed, and to get the drainage or food pieces from the patient’s face, if necessary. Thus, injuries can be avoided with the maintenance of patient’s dignity.

It is important to encourage the patient to be aware of the affected body part and check on its position. The family and the patient should be motivated to enhance coping with activities and release the growing tension.

It is recommended to get advice from the physical and occupational therapists regarding the exercising programs and adaptive equipment. The family should be referred to corresponding support groups and provided with community resources.

  • Patients Should Adapt to a New Reality

The patient has to compensate the injury and dysfunction adapting to a new reality. A good unilateral neglect care plan implies encouraging client to perform all the activities he or she can. The coping skills should be enhanced to attain the goals, eliminate unwillingness to live and function, and deal with the new reality.

  • Patients Should Be Aware of the Affected Parts

A nurse should manipulate, stroke, and touch the neglected patient’s parts to help the patient to be aware of how to deal with it. It is recommended to give the objects of various sizes, texture, and weight to the patient to keep attention and ensure tactile stimuli.

  • Patients Should Discuss the Concerns of Safety

Patients should be able to navigate the familiar environments being aware of risks and able to prevent them.

  • Patients Should Do Rehabilitation

According to the recommendations of neuropsychological therapists, patients should do exercises, show improvement and recover within a month or so.

  • Patients Should Turn Head and Eyes

Looking around, the patients make the awareness of the surrounding better and compensate for the visual losses. 

  • Patients Should Find a Method of Safe Placing of Limbs

It is the function of the caregiver to educate the patient on how to align the affected limbs and prevent injuries caused by pressure or decreased sensation.

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