Hye Won (Casey) Kim
Teaching Assignment
1. B. T. is a 69-year-old female who initially presented for left-sided weakness, diagnosed
with acute stroke due to occlusion of right middle cerebral artery and non-traumatic
subarachnoid hemorrhage.
2. The patient was in partial denial of her current health status, affecting her readiness to
learn. She stated that she is fine but agreed to go through with the teaching.
3. Language and reading materials were formatted at a 5th grade reading level and free of
nursing/medical jargon.
4. The patient was given a pamphlet titled “After a Stroke” by Kaiser Permanente with all
the teaching material included. The patient wore her glasses while following along. The
patient’s primary preferred language was English, which was consistent with the
pamphlet.
Teaching provided:
What type of stroke did you have? Where is the location of your stroke?
“I had a bleeding stroke, and it is right sided.”
Signs/symptoms of stroke: BE FAST
 Balance (sudden change in balance or coordination)
 Eyes (vision changes; vision loss or double vision meaning you may see two of an object)
 Face (facial droop, your face may look uneven)
 Arms/legs (weakness)
 Speech (slurred speech, which means there is sudden difficulty in speaking or you cannot
speak clearly)
 Time (don’t stall, CALL)
Hemorrhagic stroke:
 A hemorrhagic, or bleeding, stroke happens when a blood vessel in the brain breaks.
Blood can leak into the brain and kill brain cells.
Right-sided stroke:
 With right-sided stroke, it will affect the left side of your body and you may have a hard
time paying attention to people or things on your left side.
Risk factors:
 Some risk factors for stroke are high blood pressure, high cholesterol, diabetes, carotid or
artery disease, previous stroke, heart disease, obesity, low activity, smoking, too much
alcohol, or using drugs. Because you have high blood pressure, high cholesterol, artery
disease, and diabetes, it is important to keep a healthy weight, stay physically active, take
your medicine, eat a heart-healthy diet, and follow up with your doctor regularly.
Heart-healthy diet:
 A heart-healthy diet is to lower sodium. Sodium is in the salt you add to your food, but
most of the sodium comes from processing of food. It is important to choose healthier
foods. A good way to plan or prepare your meals is to follow the “healthy plate” method,
which is to fill half of your plate with non-starchy vegetables (e.g., broccoli, cabbage,
carrots, greens, peppers, tomatoes, zucchini), one-quarter with healthy low-salt starches
or grains (e.g., brown rice, quinoa, or barley), and one-quarter with a healthy protein
source (e.g., fish, eggs, tofu, chicken, turkey, or beans). It is also important to eat at least
3 servings of fruit, low-fat dairy, and healthy fats (e.g., avocado, olive oil) for balanced
nutrition. Try to include exercise as well, such as walking, light strength exercises, and
stretching.
Rehab:
 Because you have weakness of your left side of your body, you were referred to
rehabilitation. Physical therapy will help you with tasks such as getting in/out of your
bed, walking, or using a wheelchair as well as addressing problems with balance,
coordination, and strength. Occupational therapy will help you with your daily tasks to
take care of yourself, such as brushing your teeth, dressing yourself, bathing, and eating
by yourself. Speech therapy might be needed for patients that have trouble swallowing or
communicating.
Reflection
The patient was attentive while I was educating her about her condition. Although she was in
partial denial, she was showing non-verbal cues of active listening, such as making eye contact,
nodding along, and facing me as I was speaking. Since it was a lot of information, I used the
“teach back” method throughout by asking her to tell me what she learned from my teaching.
She was able to verbalize what kind of stroke she had, how to tell if she were to have another
stroke, some risk factors, her other medical conditions that increase risk, what kind of foods she
can include in her diet, and what kind of rehab she may participate in. I think stopping frequently
to ask her these questions were helpful in keeping her attentive and making sure she was
understanding what I was saying.
References
Kaiser Permanente. (2018). After a stroke [Pamphlet]. Southern California Permanente Medical
Group.